Individual
LARRY W. KRAISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-8301
Mailing address
PO BOX 413035, SALT LAKE CITY, UT 84141-3035
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
294502-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770001818
RAILROAD MEDICARE
UT
Enumeration date
10/13/2006
Last updated
11/17/2021
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