Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 38156 | OK |
NPI | 1003445883 |
---|---|
Provider Name | Madison Ryanne Craft |
First Address | Oklahoma City, OK 73104-5018 |
Second Address | Oklahoma City, OK 73104-5018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2020 |
Last Update Date | 01/06/2021 |