MEDICARE: JESS KRAFT DPM PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP1100X	Podiatric Clinic/Center	00661	MI

General Provider Information

NPI Number	:	1386814978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESS KRAFT DPM PC

Provider Business Mailing Address
First Line	:	27920 ARLINGTON DR
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-5605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	27920 ARLINGTON DR
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-5605
Country	:	US
Telephone Number	:	248-353-1221
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JESS KRAFT
Credential	:	DPM
Telephone Number	:	248-353-1221

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	03/10/2008

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