Organization
EDMOND PEDIATRICS
Active
Organization
EDMOND PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY FREDRICK KROUS (MD)
(405) 381-8600
Entity
Organization
Contact information
Practice address
2109 N KELLY AVE, EDMOND, OK 73003-3908
(405) 513-8880
(405) 285-5912
Mailing address
2109 N KELLY AVE, EDMOND, OK 73003-3908
(405) 513-8880
(405) 285-5912
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21244
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100208810A
—
OK
Enumeration date
12/06/2012
Last updated
04/15/2024
Update your record
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