Healthcare Provider Details

I. General information

NPI: 1871529198
Provider Name (Legal Business Name): DAVID PRICE KRAFT M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10507 E 91ST ST SUITE 210
TULSA OK
74133-5589
US

IV. Provider business mailing address

10507 E 91ST ST SUITE 210
TULSA OK
74133-5589
US

V. Phone/Fax

Practice location:
  • Phone: 918-307-5450
  • Fax: 918-307-5451
Mailing address:
  • Phone: 918-307-5450
  • Fax: 918-307-5451

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:
Title or Position:
Credential:
Phone: