Krueger, Kenneth J

Krueger, Kenneth J is an individual health care provider with primary practice located at 4725 Statesmen Dr Ste A , Indianapolis IN 46250-5645. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Krueger, Kenneth J can be contacted via phone (317) 713-1111.

Contact Information

Primary practice address
4725 Statesmen Dr Ste A Indianapolis IN 46250-5645
Phone: (317) 713-1111
Fax: (317) 713-1100
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 07000391A Indiana

Profile Details

NPI number 1538159231
LBN Legal business name Krueger, Kenneth J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Apr 5th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538159231 NPPES
Indiana Other 000000344455 ANTHEM BLUE CROSS AND BLUE SHIELD
Indiana MEDICAID 100060080 ANTHEM BLUE CROSS AND BLUE SHIELD

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