Healthcare Provider Details

I. General information

NPI: 1962065300
Provider Name (Legal Business Name): JOHN CROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 NE 13TH ST # 3G3210
OKLAHOMA CITY OK
73104-5008
US

IV. Provider business mailing address

940 NE 13TH ST # 3G3210
OKLAHOMA CITY OK
73104-5008
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8600
  • Fax:
Mailing address:
  • Phone: 405-271-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34970
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number34970
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: