Individual
MICKEY E. CRITTENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1919 E MEMORIAL RD, OKLAHOMA CITY, OK 73131-1253
(405) 341-7009
(405) 340-1817
Mailing address
4401 W MEMORIAL RD, SUITE #140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11345
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100110500B
—
OK
01
—
11345
LICENSE
OK
01
—
15429
OBNDD
OK
Enumeration date
07/04/2006
Last updated
04/28/2014
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