Provider Demographics
NPI:1033397567
Name:CROW, TOBIN SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:TOBIN
Middle Name:SCOTT
Last Name:CROW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-269-5712
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:815 N LINCOLN AVE STE G
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-1641
Practice Address - Country:US
Practice Address - Phone:417-354-1500
Practice Address - Fax:417-354-1505
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4510207Q00000X
MO2019033337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200135940BMedicaid
OKOKAAA1992Medicare PIN