Healthcare Provider Details

I. General information

NPI: 1760709323
Provider Name (Legal Business Name): VINTON CRAIG HITCHCOCK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2010
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E EUFAULA ST
NORMAN OK
73069-6017
US

IV. Provider business mailing address

310 12TH AVE NE
NORMAN OK
73071-5238
US

V. Phone/Fax

Practice location:
  • Phone: 405-447-4499
  • Fax:
Mailing address:
  • Phone: 405-579-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: