Provider Demographics
NPI:1205023538
Name:D. PRICE KRAFT M.D. INC.
Entity Type:Organization
Organization Name:D. PRICE KRAFT M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:D.
Authorized Official - Middle Name:PRICE
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-671-2157
Mailing Address - Street 1:6585 S YALE AVE
Mailing Address - Street 2:SUITE 630
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8384
Mailing Address - Country:US
Mailing Address - Phone:918-671-2157
Mailing Address - Fax:
Practice Address - Street 1:6585 S YALE AVE
Practice Address - Street 2:SUITE 630
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8384
Practice Address - Country:US
Practice Address - Phone:918-671-2157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12228207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK17662OtherBUREAU OF NARCOTICS DRUGS
OK12228OtherOKLAHOMA MEDICAL LICENSE
AZ43585OtherAZ MEDICAL LICENSE
OK03254603368Medicaid
OK03254603368Medicaid
OK12228OtherOKLAHOMA MEDICAL LICENSE
AZ43585OtherAZ MEDICAL LICENSE