MEDICARE: MR. BILLY DON CROW JR. CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	CTP-000114	AR
2	367500000X	Certified Registered Nurse Anesthetist	R0082272	OK
3	367500000X	Certified Registered Nurse Anesthetist	CO280CRNA	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	900522349	OTHER	OK	MEDICARE GROUP PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194832329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BILLY DON CROW JR. CRNA

Provider Business Mailing Address
First Line	:	2323 N OAK GROVE RD
Second Line	:
City	:	DRUMRIGHT
State	:	OK
Zip	:	74030-5660
Country	:	US
Telephone Number	:	918-549-5596
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 N OAK GROVE RD
Second Line	:
City	:	DRUMRIGHT
State	:	OK
Zip	:	74030-5660
Country	:	US
Telephone Number	:	918-549-5596
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	03/22/2018

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Directions to “ MR. BILLY DON CROW JR. CRNA” Practice Location

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