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NPI 1972555613

NPI 1972555613 : JAMES G CROTTY DPM : MUSKOGEE, OK

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General NPI Number Information
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    NPI Number           |    1972555613
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES G CROTTY DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/17/2006
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    Last Update Date     |    11/23/2010
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Provider Practice Location Address
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    Address Line         |    1221 W BROADWAY ST 
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    City                 |    MUSKOGEE
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    State                |    OK
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    Zip                  |    74401-6249
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    Country              |    US
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    Telephone            |    918-682-1720
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    Fax                  |    918-682-1332
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Provider Business Mailing Address
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    Address Line         |    1221 W BROADWAY ST 
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    City                 |    MUSKOGEE
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    State                |    OK
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    Zip                  |    74401-6249
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    Country              |    US
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    Telephone            |    918-682-1720
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    Fax                  |    918-682-1332
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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        |    213ES0103X
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    Taxonomy Name        |    Foot & Ankle Surgery Podiatrist
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    License Number       |    170
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    License Number State |    OK
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