Provider Demographics
NPI:1811019185
Name:CROWE, RONNIE EDWARD
Entity Type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:EDWARD
Last Name:CROWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 S MADISON PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7810
Mailing Address - Country:US
Mailing Address - Phone:918-906-7986
Mailing Address - Fax:866-757-1708
Practice Address - Street 1:5640 S MADISON PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7810
Practice Address - Country:US
Practice Address - Phone:918-906-7986
Practice Address - Fax:866-757-1708
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications