Individual
KEVIN CROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 PIERCE ST, SUITE 217, KINGSTON, PA 18704-5149
(570) 714-8614
(570) 714-8616
Mailing address
250 PIERCE ST, SUITE 217, KINGSTON, PA 18704-5149
(570) 714-8614
(570) 714-8616
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD044097L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012448150003
—
PA
Enumeration date
09/17/2006
Last updated
12/21/2009
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