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General NPI Number Information
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NPI Number | 1376512442
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Entity Type | Individual
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Provider Name | FRED JAMES CRAPSE JR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 519 N MAIN ST
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City | BRISTOW
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State | OK
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Zip | 74010-2016
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Country | US
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Telephone | 918-701-2365
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Fax | 918-367-5272
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Provider Business Mailing Address
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Address Line | 1809 E 13TH ST STE 300
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City | TULSA
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State | OK
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Zip | 74104-4431
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Country | US
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Telephone | 918-701-2313
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Fax | 918-513-7303
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 3347
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License Number State | OK
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