Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | DR.0033354 | CO |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 33354 | CO |
NPI | 1811978281 |
---|---|
Provider Name | John T Crane |
First Address | Loveland, CO 80538-5004 |
Second Address | Loveland, CO 80538-5004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 01/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01333541 | (05) | CO |
117620000 | (05) | WY |
CR99314 | ANTHEM BCBS (01) | CO |
F34676 | (02) | CO |