Organization
KEVIN W CROFT, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WALLACE CROFT M.D. (OWNER)
(580) 924-5211
Entity
Organization
Contact information
Practice address
5389 N 1ST AVE, DURANT, OK 74701-2599
(580) 924-5211
Mailing address
5389 N 1ST AVE, DURANT, OK 74701-2599
(580) 924-5211
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
19261
OK
207W00000X
Ophthalmology Physician
32094
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744780A
—
OK
Enumeration date
11/02/2006
Last updated
06/24/2016
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