Organization
CRAIG S TUTTON MD, INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOUVANNAKAYSONE TUTTON RN (OFFICE MANAGER)
(580) 224-0331
Entity
Organization
Contact information
Practice address
1212 MERRICK DR, ARDMORE, OK 73401-1824
(580) 224-0331
(580) 224-0334
Mailing address
PO BOX 1466, ARDMORE, OK 73402-1466
(580) 224-0331
(580) 224-0334
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
20688
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100726670A/100053740
—
OK
Enumeration date
08/17/2006
Last updated
08/22/2020
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