Healthcare Provider Details

I. General information

NPI: 1528249166
Provider Name (Legal Business Name): JAMES M CRUTCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NE 10TH ST
OKLAHOMA CITY OK
73117-1207
US

IV. Provider business mailing address

1000 NE 10TH ST
OKLAHOMA CITY OK
73117-1207
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4000
  • Fax: 405-271-3431
Mailing address:
  • Phone: 405-271-4000
  • Fax: 405-271-3431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number13367
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: