Provider Demographics
NPI:1265549729
Name:CRAIG, LATASHA BARKER (MD)
Entity type:Individual
Prefix:DR
First Name:LATASHA
Middle Name:BARKER
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LATASHA
Other - Middle Name:JEAN
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 N LINCOLN BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-3252
Mailing Address - Country:US
Mailing Address - Phone:405-271-1616
Mailing Address - Fax:405-271-9222
Practice Address - Street 1:1000 N LINCOLN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-3252
Practice Address - Country:US
Practice Address - Phone:405-271-1616
Practice Address - Fax:405-271-9222
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25252207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200114900AMedicaid
OKI64689Medicare UPIN
OK300522098Medicare PIN