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General NPI Number Information
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NPI Number | 1225397797
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Entity Type | Individual
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Provider Name | SCOTT A KREITZBERG D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 8010 S 101ST EAST AVE STE 100
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City | TULSA
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State | OK
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Zip | 74133-4562
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Country | US
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Telephone | 918-940-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 8010 S 101ST EAST AVE STE 100
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City | TULSA
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State | OK
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Zip | 74133-4562
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Country | US
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Telephone | 918-940-4700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5315085034
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5101019676
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 6831
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License Number State | OK
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