Mark Krause, DPM
Podiatrist in Fort Defiance, AZ
Registered providerLicense # listed (TX)TX license current (TDLR)Medicare-enrolledAccepts Medicare assignment
Public-record details
- Address
- Corner of Route N12 and N7, Fort Defiance, AZ 86504
- Phone
- (928) 729-8825
- Listed under
- Individual podiatrists
- NPI
- 1750341962
- NPI status
- Active in the NPPES registry
- Provider type
- Individual provider
- Registered specialty (self-reported taxonomy)
- Podiatrist (213E00000X)
- Credentials listed
- DPM
- License number on NPI record
- 1321 (TX)
- NPI first issued
- Mar 23, 2006
- Years since NPI first issued
- 20 years (since 2006)
- License state on NPI record
- TX
- NPI record last updated
- May 31, 2019
- Texas license status (TDLR)
- Current, expires Nov 1, 2028
- Texas license first issued (TDLR)
- Jul 19, 1996
- Medicare enrollment (CMS)
- Enrolled: listed in CMS Doctors & Clinicians
- Medicare assignment (CMS)
- Accepts the Medicare-approved amount as payment in full
- Professional school graduation (CMS)
- 1995 (31 years ago)
- Medicare group practice (CMS)
- Pine Ridge Indian Health Service Hospital (10 clinicians); Pine Ridge Indian Health Service Hospital (8 clinicians)
- Practice locations on file with Medicare (CMS)
- 2
- Other podiatry listings at this street address
- 6
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