Provider Demographics
NPI:1407279276
Name:STEPHANIE K KRAFT MD PC
Entity Type:Organization
Organization Name:STEPHANIE K KRAFT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-851-9533
Mailing Address - Street 1:10371 PARKGLENN WAY
Mailing Address - Street 2:#290
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3885
Mailing Address - Country:US
Mailing Address - Phone:720-851-9533
Mailing Address - Fax:720-851-9553
Practice Address - Street 1:10371 PARKGLENN WAY
Practice Address - Street 2:#290
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3885
Practice Address - Country:US
Practice Address - Phone:720-851-9533
Practice Address - Fax:720-851-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty