Individual
DR. ETHAN TERRY KRAFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13359 ISLE DR, STE 1, BAXTER, MN 56425-2223
(218) 454-3077
(888) 835-7231
Mailing address
13359 ISLE DR, STE 1, BAXTER, MN 56425-2223
(218) 454-3077
(888) 835-7231
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
71666
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2017
Last updated
11/14/2022
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