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General NPI Number Information
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NPI Number | 1356597330
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Entity Type | Individual
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Provider Name | RYAN THOMAS KRAFFT D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 17 MEDICAL PLZ STE 2
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-2918
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Country | US
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Telephone | 870-424-7070
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Fax | 870-424-6616
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Provider Business Mailing Address
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Address Line | PO BOX 707
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City | MOUNTAIN HOME
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State | AR
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Zip | 72654-0707
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Country | US
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Telephone | 870-424-7070
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Fax | 870-424-6616
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 1656
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | E9758
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DO 5101018562
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License Number State | MI
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