Provider Demographics
NPI:1871529198
Name:KRAFT, DAVID PRICE (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:PRICE
Last Name:KRAFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10507 E 91ST ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5589
Mailing Address - Country:US
Mailing Address - Phone:918-307-5450
Mailing Address - Fax:918-307-5451
Practice Address - Street 1:10507 E 91ST ST
Practice Address - Street 2:SUITE 210
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5589
Practice Address - Country:US
Practice Address - Phone:918-307-5450
Practice Address - Fax:918-307-5451
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12228207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK12228OtherOKLAHOMA MEDICAL LICENSE
OK17662OtherBUREAU OF NARCOTICS DRUGS
OKAK8912823OtherDRUG ENFORCEMENT AGENCY#
OK12228OtherOKLAHOMA MEDICAL LICENSE
OK17662OtherBUREAU OF NARCOTICS DRUGS