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General NPI Number Information
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NPI Number | 1558898114
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Entity Type | Individual
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Provider Name | KRISTOFOR JAMES KALVIG DPM
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Gender | Male
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 3315 E 47TH PL STE 102
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City | TULSA
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State | OK
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Zip | 74135-2911
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Country | US
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Telephone | 918-951-0968
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Fax | 918-749-2350
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Provider Business Mailing Address
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Address Line | 3315 E 47TH PL STE 102
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City | TULSA
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State | OK
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Zip | 74135-2911
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Country | US
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Telephone | 918-951-0968
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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 | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 1062
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1062
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License Number State | MN
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