Individual
DAVID M KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD PA
Contact information
Practice address
709 2ND ST, JACKSON, MN 56143-1647
(507) 847-5951
(507) 847-5957
Mailing address
709 2ND ST, PO BOX 89, JACKSON, MN 56143-1647
(507) 847-5951
(507) 847-5957
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN1915
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410040208
MEDICARE RAILROAD
MN
01
—
419000451
MEDICARE PTAN
MN
05
—
826523200
—
MN
Enumeration date
08/26/2005
Last updated
08/18/2011
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