Individual
IAN PAUL KROUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1195 N MAIN ST, PROVIDENCE, RI 02904-1824
(401) 861-3782
(401) 383-5846
Mailing address
70 S BAY DR, UNIT A2, NARRAGANSETT, RI 02882-2870
(860) 460-7361
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00398
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00398
RI LICENSE PA#
RI
Enumeration date
03/22/2006
Last updated
09/16/2019
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