MEDICARE: FESTUS J KREBS III M.D.

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	174400000X	Specialist	R4E33	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020007385	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	13398011	OTHER	MO	BCBSKC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649273541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FESTUS J KREBS III M.D.

Provider Business Mailing Address
First Line	:	296 NE TUDOR RD
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-5696
Country	:	US
Telephone Number	:	816-524-4828
Fax Number	:	816-524-4888

Provider Business Practice Location Address
First Line	:	296 NE TUDOR RD
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-5696
Country	:	US
Telephone Number	:	816-524-4828
Fax Number	:	816-524-4888

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	06/02/2008

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