Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 40540 | SC |
NPI | 1225358005 |
---|---|
Provider Name | Dr. John Clayton Crantford |
First Address | Summerville, SC 29483-6656 |
Second Address | Summerville, SC 29483-6656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2010 |
Last Update Date | 07/05/2019 |