1023236064 NPI number — MRS. DEBORAH KRAFFT BEICHLER PT

Table of content: MRS. DEBORAH KRAFFT BEICHLER PT (NPI 1023236064)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023236064 NPI number — MRS. DEBORAH KRAFFT BEICHLER PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEICHLER
Provider First Name:
DEBORAH
Provider Middle Name:
KRAFFT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BEICHLER
Provider Other First Name:
DEBBI
Provider Other Middle Name:
KRAFFT
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1023236064
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15703 E 79TH ST N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWASSO
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74055-7008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-272-4199
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6585 S YALE AVE
Provider Second Line Business Practice Location Address:
SUITE 445
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74136-8384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-481-2977
Provider Business Practice Location Address Fax Number:
918-481-2976
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  124464 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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