Provider Demographics
NPI:1932238474
Name:MICHAEL K CRAWFORD PC
Entity Type:Organization
Organization Name:MICHAEL K CRAWFORD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-748-4343
Mailing Address - Street 1:13321 N MERIDIAN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8356
Mailing Address - Country:US
Mailing Address - Phone:405-748-4343
Mailing Address - Fax:405-748-5040
Practice Address - Street 1:13321 N MERIDIAN AVE STE 210
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8356
Practice Address - Country:US
Practice Address - Phone:405-748-4343
Practice Address - Fax:405-748-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14749207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK586091296002OtherBLUE CROSS BLUE SHIELD
OK5078297OtherAETNA
OK671856OtherFIRST HEALTH
OK671856OtherFIRST HEALTH