Basic Information
| Provider Information | |||||||||
| NPI: | 1780623959 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUMMERS | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | X | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 WESTCHESTER DR | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731201427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053978588 | ||||||||
| FaxNumber: | 4052862667 | ||||||||
| Practice Location | |||||||||
| Address1: | 1102 W MACARTHUR ST | ||||||||
| Address2: | |||||||||
| City: | SHAWNEE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 748041743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058788183 | ||||||||
| FaxNumber: | 4058788101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 25295 | OK | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.