Organization
DAVID M KRUSE OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M KRUSE OD PA (OPTOMETRIST)
(507) 847-5951
Entity
Organization
Contact information
Practice address
709 2ND ST, JACKSON, MN 56143-1647
(507) 847-5951
(597) 847-5957
Mailing address
709 2ND ST, JACKSON, MN 56143-1647
(507) 847-5951
(507) 847-5957
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN1915
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015968001
MEDICARE DME
MN
01
—
48476KR
BLUE CROSS BLUE SHIELD
MN
05
—
826523200
—
MN
01
—
DQ7129
MEDICARE RAILROAD
MN
Enumeration date
06/11/2007
Last updated
08/18/2011
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