Provider Demographics
NPI:1295964823
Name:PRICE, KRISTINA (DO)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W 2ND ST STE 600
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-6709
Mailing Address - Country:US
Mailing Address - Phone:800-993-8244
Mailing Address - Fax:866-705-6405
Practice Address - Street 1:302 W 2ND ST STE 600
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-6709
Practice Address - Country:US
Practice Address - Phone:800-993-8244
Practice Address - Fax:866-705-6405
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-00671207Q00000X
OK4800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine