Provider Demographics
NPI:1376512442
Name:CRAPSE, FRED JAMES JR (DO)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:JAMES
Last Name:CRAPSE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 E 13TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4431
Mailing Address - Country:US
Mailing Address - Phone:918-701-2313
Mailing Address - Fax:918-513-7303
Practice Address - Street 1:519 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:OK
Practice Address - Zip Code:74010-2016
Practice Address - Country:US
Practice Address - Phone:918-701-2365
Practice Address - Fax:918-367-5272
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3347208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG30814Medicare UPIN