MEDICARE: KERRY CRANMER M.D.

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	207Q00000X	Family Medicine Physician	10880	OK

General Provider Information

NPI Number	:	1629010517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRY CRANMER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 19635
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73144-0635
Country	:	US
Telephone Number	:	405-692-2118
Fax Number	:	405-605-5816

Provider Business Practice Location Address
First Line	:	3545 NW 58TH ST
Second Line	:	STE 750
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4726
Country	:	US
Telephone Number	:	405-692-2118
Fax Number	:	405-605-5816

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/08/2007

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Directions to “ KERRY CRANMER M.D.” Practice Location

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