MEDICARE: ROBERT MARK KRAUS MD

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	207R00000X	Internal Medicine Physician	10102	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54096	OTHER	TN	BLUE CROSS
2	4110758	OTHER	TN	AETNA

General Provider Information

NPI Number	:	1396843918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MARK KRAUS MD

Provider Business Mailing Address
First Line	:	1211 UNION AVE STE 330
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-6655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7550 WOLF RIVER BLVD STE 103
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-1779
Country	:	US
Telephone Number	:	901-761-9097
Fax Number	:	901-682-7635

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/16/2025

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