Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | ME40493 | FL |
NPI | 1114926474 |
---|---|
Provider Name | Crawford Haralson Cleveland |
First Address | Pensacola, FL 32503-8318 |
Second Address | Pensacola, FL 32503-8318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 06/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
066944000 | (05) | FL |
D61989 | (02) |