Provider Demographics
NPI:1609820034
Name:MCCREARY, EDWIN LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:LYNN
Last Name:MCCREARY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1245 S UTICA AVE
Mailing Address - Street 2:FL 1
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4214
Mailing Address - Country:US
Mailing Address - Phone:918-579-3850
Mailing Address - Fax:918-579-3859
Practice Address - Street 1:1809 E 13TH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4419
Practice Address - Country:US
Practice Address - Phone:918-579-3850
Practice Address - Fax:918-579-3859
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-01-12
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Provider Licenses
StateLicense IDTaxonomies
OK22240207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100137340AMedicaid
OKOKA102983Medicare PIN