Provider Demographics
NPI:1851764856
Name:MCCRARY, JONATHON MICHAEL (PA-C)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:MICHAEL
Last Name:MCCRARY
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:918-499-4855
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6151 S YALE AVE STE 100A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1929
Practice Address - Country:US
Practice Address - Phone:918-494-8500
Practice Address - Fax:918-307-5578
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2023-01-26
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Provider Licenses
StateLicense IDTaxonomies
ARP-T1548363AS0400X
OK4677363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical