Provider Demographics
NPI:1548258544
Name:CRIMMINS, CHRISTOPHER R (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:R
Last Name:CRIMMINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2120 W ELK AVE
Mailing Address - Street 2:STE. 2
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1569
Mailing Address - Country:US
Mailing Address - Phone:580-251-1050
Mailing Address - Fax:580-251-1035
Practice Address - Street 1:2120 W ELK AVE
Practice Address - Street 2:STE. 2
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1569
Practice Address - Country:US
Practice Address - Phone:580-251-1050
Practice Address - Fax:580-251-1035
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2011-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK24110208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKRAILROAD MEDICAREOtherP00179931
OK0915990004OtherMEDICARE PTAN
OK200031610AMedicaid
OK200031610AMedicaid
OKRAILROAD MEDICAREOtherP00179931