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Individual

DR. KEVIN WALLACE CROFT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5389 N 1ST AVE, DURANT, OK 74701
(580) 924-5211
(580) 924-6351
Mailing address
5389 N 1ST AVE, DURANT, OK 74701-2599
(580) 924-5211
(580) 924-6351

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
19261
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100040310C
OK
05
100744780A
OK
Enumeration date
07/30/2006
Last updated
05/22/2018
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