Provider Demographics
NPI:1497188791
Name:RACHEL M CRAIN MD PLLC
Entity Type:Organization
Organization Name:RACHEL M CRAIN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-604-4818
Mailing Address - Street 1:PO BOX 270836
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73137-0836
Mailing Address - Country:US
Mailing Address - Phone:405-604-4818
Mailing Address - Fax:405-604-4847
Practice Address - Street 1:3330 NW 56TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4479
Practice Address - Country:US
Practice Address - Phone:405-604-4818
Practice Address - Fax:405-604-4847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-10
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26329207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty