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Individual

DR. JODI LYNN KRUEGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2011 WINDSOR SPRING ROAD, AUGUSTA, GA 30906
(706) 798-1700
(706) 798-8626
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 922-8251
(706) 922-6695

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
056123
GA
207Q00000X
Family Medicine Physician
Primary
56123
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056123
LICENSE
GA
01
10057033
AMERIGROUP
GA
01
336988
WELLCARE
GA
01
56123
GA
GA
05
599460869A
GA
01
CH0654
RR MEDICARE GROUP PIN
GA
05
G56123
SC
Enumeration date
06/25/2006
Last updated
04/20/2026
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