Organization
GOLDEN CARE PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH KRUEGER DPM (PRESIDENT)
(317) 713-1111
Entity
Organization
Contact information
Practice address
4725 STATESMEN DR, SUITE A, INDIANAPOLIS, IN 46250-5645
(317) 713-1100
(317) 713-1100
Mailing address
4725 STATESMEN DR, SUITE A, INDIANAPOLIS, IN 46250-5645
(317) 713-1100
(317) 713-1100
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000344455
ANTHEM BLUE CROSS BLUE SHIELD
IN
05
—
100239180
—
IN
Enumeration date
09/12/2007
Last updated
07/02/2019
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