Organization
JOHN S KRISTOFERSON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SEVERIN KRISTOFERSON MD (PRESIDENT)
(940) 382-6757
Entity
Organization
Contact information
Practice address
3325 MEDPARK DR, DENTON, TX 76210
(940) 382-6757
(940) 383-1894
Mailing address
3325 MEDPARK DR, DENTON, TX 76210-6898
(940) 382-6757
(940) 383-1894
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F6842
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020KD
BCBS GROUP
TX
05
—
033570501
—
TX
01
—
1003801416
VICKIE KRAHL NPI INDIVI
TX
01
—
1235124314
INDIVIDUAL NPI
TX
01
—
200002820
PALMETTO GBA RAILROAD
TX
01
—
89N936
VICKIE BCBS
TX
01
—
8J2030
BCBS INDIVIDUAL
TX
Enumeration date
04/26/2007
Last updated
08/20/2018
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