Provider Demographics
NPI:1962478057
Name:CRANE, DAVID L (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:CRANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 NW 125TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8804
Mailing Address - Country:US
Mailing Address - Phone:405-752-1796
Mailing Address - Fax:405-752-1796
Practice Address - Street 1:3804 NW 125TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8804
Practice Address - Country:US
Practice Address - Phone:405-752-1796
Practice Address - Fax:405-752-1796
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK10567207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100134870Medicaid