MEDICARE: DR. JOHN CLAYTON CRANTFORD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0122X	Plastic and Reconstructive Surgery Physician	40540	SC

General Provider Information

NPI Number	:	1225358005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CLAYTON CRANTFORD M.D.

Provider Business Mailing Address
First Line	:	102 W 8TH NORTH ST STE B
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-6656
Country	:	US
Telephone Number	:	843-471-1135
Fax Number	:	800-919-5720

Provider Business Practice Location Address
First Line	:	102 W 8TH NORTH ST STE B
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-6656
Country	:	US
Telephone Number	:	843-471-1135
Fax Number	:	800-919-5720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	05/07/2019

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