Individual
GUS W KRUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1439 JESSE JEWELL PKWY NE STE 202, GAINESVILLE, GA 30501-3806
(770) 219-0023
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H8942
TX
207R00000X
Internal Medicine Physician
Primary
97579
GA
207R00000X
Internal Medicine Physician
H8942
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150198301
—
TX
01
—
8F8250
BCBS
TX
Enumeration date
07/10/2006
Last updated
08/01/2025
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