Healthcare Provider Details

I. General information

NPI: 1194832329
Provider Name (Legal Business Name): BILLY DON CROW JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 N OAK GROVE RD
DRUMRIGHT OK
74030-5660
US

IV. Provider business mailing address

2323 N OAK GROVE RD
DRUMRIGHT OK
74030-5660
US

V. Phone/Fax

Practice location:
  • Phone: 918-549-5596
  • Fax:
Mailing address:
  • Phone: 918-549-5596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCTP-000114
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR0082272
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCO280CRNA
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: