Individual
DR. JOHN TIMOTHY KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 436-3980
(580) 421-6283
Mailing address
1925 WARRIOR WAY, ADA, OK 74820-3491
(580) 421-4570
(580) 421-6283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25027
OK
207Q00000X
Family Medicine Physician
E4605
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05110013100
QUALCHOICE
AR
05
—
1285600262
—
IA
05
—
158169001
—
AR
05
—
200102360B
—
OK
01
—
5N390
BLUE CROSS/BLUE SHIELD
AR
01
—
8436548
CIGNA
AR
01
—
P00260757
RAILROAD MEDICARE
AR
Enumeration date
02/28/2006
Last updated
07/10/2024
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