Provider Demographics
NPI:1689097339
Name:CRAWFORD, MICHAEL JOE (PA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOE
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:825 E ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6610
Mailing Address - Country:US
Mailing Address - Phone:405-364-7900
Mailing Address - Fax:405-310-6866
Practice Address - Street 1:4217 28TH AVE NW STE 111
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8358
Practice Address - Country:US
Practice Address - Phone:405-310-4211
Practice Address - Fax:405-857-7215
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2023-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2315363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK338834YWKNOtherMEDICARE