Provider Demographics
NPI:1861436677
Name:CROW, THOMAS RAY (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RAY
Last Name:CROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 DUNCAN REGIONAL LOOP
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1564
Mailing Address - Country:US
Mailing Address - Phone:580-251-6655
Mailing Address - Fax:
Practice Address - Street 1:9170 US HWY 70
Practice Address - Street 2:
Practice Address - City:WAURIKA
Practice Address - State:OK
Practice Address - Zip Code:73573
Practice Address - Country:US
Practice Address - Phone:580-228-3669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16480207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731561322OtherCOMMERCIAL INSURANCE
OK100200840AMedicaid
OK080189628OtherPALMETTO GBA
OK731561322OtherCOMMERCIAL INSURANCE
OK$$$$$$$$$005OtherBLUE CROSS BLUE SHIELD
OK731561322OtherCOMMERCIAL INSURANCE