Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 35039946C | OH |
NPI | 1205820529 |
---|---|
Provider Name | Susan Ellen Crapes |
First Address | Athens, OH 45701-5405 |
Second Address | Athens, OH 45701-1662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 03/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000118708 | ANTHEM (01) | OH |
0100324 | UNITED HEALTHCARE MC (01) | |
0100340 | UNITED HEALTHCARE -NL (01) | |
0489136 | (05) | OH |
311155352 | AETNA (01) | |
311155352 | CENTRAL BENEFITS (01) | |
311155352 | CIGNA/CONN GEN (01) | |
311155352 | E V BENEFITS (01) | |
311155352 | EMERALD HEALTH (01) | |
311155352 | GREAT WEST (01) | |
311155352 | NATIONWIDE (01) | |
311155352 | OHIO HEALTH CHOICE (01) | OH |
311155352 | PPO NEXT (01) | |
311155352 | TRICARE (01) | |
A77283 | (02) |