Individual
WILLEM J KRUGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0156
(812) 801-0276
Mailing address
PO BOX 189, MADISON, IN 47250-0189
(812) 801-0156
(812) 801-0276
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02002076
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108109
ANTHEM BCBS
IN
01
—
050071818
MEDICARE RAILROAD
—
05
—
100320110A
—
IN
01
—
1097668
PASSPORT KY MEDICAID
KY
01
—
2436181000
PASSPORT ADVANTAGE
KY
01
—
4123371
AETNA
—
01
—
419199P
SIHO
IN
05
—
64022478
—
KY
Enumeration date
07/03/2006
Last updated
04/23/2015
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