Healthcare Provider Details

I. General information

NPI: 1205023538
Provider Name (Legal Business Name): D. PRICE KRAFT M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 S YALE AVE SUITE 630
TULSA OK
74136-8384
US

IV. Provider business mailing address

6585 S YALE AVE SUITE 630
TULSA OK
74136-8384
US

V. Phone/Fax

Practice location:
  • Phone: 918-671-2157
  • Fax:
Mailing address:
  • Phone: 918-671-2157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number12228
License Number StateOK

VIII. Authorized Official

Name: DR. D. PRICE KRAFT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 918-671-2157