Provider Demographics
NPI:1790916922
Name:DEBRA A CRAWFORD, DO LLC
Entity Type:Organization
Organization Name:DEBRA A CRAWFORD, DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO LLC
Authorized Official - Phone:580-357-1002
Mailing Address - Street 1:4417 W GORE BLVD
Mailing Address - Street 2:STE 3
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5978
Mailing Address - Country:US
Mailing Address - Phone:580-357-1002
Mailing Address - Fax:580-357-1004
Practice Address - Street 1:4417 W GORE BLVD
Practice Address - Street 2:STE 3
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5978
Practice Address - Country:US
Practice Address - Phone:580-357-1002
Practice Address - Fax:580-357-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty