Organization
JOHN B. KRUEGER, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN B KRUEGER M.D. (PHYSICIAN)
(801) 253-9753
Entity
Organization
Contact information
Practice address
9660 S 1300 E, SANDY, UT 84094-3762
(801) 253-9753
(801) 253-9754
Mailing address
23 SNOWSTAR LN, SANDY, UT 84092-4800
(801) 253-9753
(801) 253-9754
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
275855-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
556475729001
—
UT
Enumeration date
12/17/2007
Last updated
04/29/2008
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