Provider Demographics
NPI:1962701573
Name:MURRAY CROW DO PC
Entity type:Organization
Organization Name:MURRAY CROW DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-246-9600
Mailing Address - Street 1:401 E BROADWAY CT
Mailing Address - Street 2:STE #C
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7939
Mailing Address - Country:US
Mailing Address - Phone:918-246-9600
Mailing Address - Fax:
Practice Address - Street 1:401 E BROADWAY CT
Practice Address - Street 2:STE #C
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7939
Practice Address - Country:US
Practice Address - Phone:918-246-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100067920AMedicaid
OK1811973076OtherINDIVIDUAL NPI
OKF68494Medicare UPIN
OK100067920AMedicaid