Provider Demographics
NPI:1972512440
Name:KRIFT, DOUGLAS PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:PATRICK
Last Name:KRIFT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 S FORT THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-2453
Mailing Address - Country:US
Mailing Address - Phone:859-781-8700
Mailing Address - Fax:859-781-8701
Practice Address - Street 1:1467 S FORT THOMAS AVE
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-2453
Practice Address - Country:US
Practice Address - Phone:859-781-8700
Practice Address - Fax:859-781-8701
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
6085102Medicare PIN
U75380Medicare UPIN
KY85001170Medicaid