Provider Demographics
NPI:1699021543
Name:CRAWFORD, DREW ALLYN (OD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:ALLYN
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6140 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1933
Mailing Address - Country:US
Mailing Address - Phone:918-252-2020
Mailing Address - Fax:918-307-1983
Practice Address - Street 1:3131 MILITARY BLVD
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-2290
Practice Address - Country:US
Practice Address - Phone:918-687-6600
Practice Address - Fax:918-687-6610
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2725152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2725OtherSTATE LICENSE NUMBER