MEDICARE: DAVID PRICE KRAFT M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	12228	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12228	OTHER	OK	OKLAHOMA MEDICAL LICENSE
2	17662	OTHER	OK	BUREAU OF NARCOTICS DRUGS

General Provider Information

NPI Number	:	1871529198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID PRICE KRAFT M.D

Provider Business Mailing Address
First Line	:	10507 E 91ST ST
Second Line	:	SUITE 210
City	:	TULSA
State	:	OK
Zip	:	74133-5589
Country	:	US
Telephone Number	:	918-307-5450
Fax Number	:	918-307-5451

Provider Business Practice Location Address
First Line	:	10507 E 91ST ST
Second Line	:	SUITE 210
City	:	TULSA
State	:	OK
Zip	:	74133-5589
Country	:	US
Telephone Number	:	918-307-5450
Fax Number	:	918-307-5451

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	03/07/2023

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Directions to “ DAVID PRICE KRAFT M.D” Practice Location

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