Provider Demographics
NPI:1568639128
Name:KRICSFELD, DAVID JEFFREY (DO, MBA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JEFFREY
Last Name:KRICSFELD
Suffix:
Gender:M
Credentials:DO, MBA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8550 MARSHALL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1505
Mailing Address - Country:US
Mailing Address - Phone:816-348-2260
Mailing Address - Fax:913-495-3751
Practice Address - Street 1:7201 E 147TH ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-4204
Practice Address - Country:US
Practice Address - Phone:816-348-2260
Practice Address - Fax:913-495-3751
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2007026041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOK67000004Medicare PIN
MOP00648668OtherRR MEDICARE
MO2007026041OtherSTATE PHYSICIAN LICENSE