Provider Demographics
NPI:1568449510
Name:KRAUS, JOHN W (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:KRAUS
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:2605 KENTUCKY AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3800
Mailing Address - Country:US
Mailing Address - Phone:270-443-8285
Mailing Address - Fax:270-442-9243
Practice Address - Street 1:2605 KENTUCKY AVE
Practice Address - Street 2:STE 202
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3800
Practice Address - Country:US
Practice Address - Phone:270-443-8285
Practice Address - Fax:270-442-9243
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY19115207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000000045406OtherANTHEM BC/BS
KY64191158Medicaid
KS000000045406OtherANTHEM BC/BS
KY64191158Medicaid