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NPI Code Detail

MEDICARE: DR. LOREN MEREDITH MCCRACKEN DMD

MEDICARE: DR. LOREN MEREDITH MCCRACKEN DMD
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
1122300000XDentist5230AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851480115
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOREN MEREDITH MCCRACKEN DMD
Provider Business Mailing Address
First Line : 2350 HARGROVE RD E
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35405-2612
Country : US
Telephone Number : 205-562-7002
Fax Number : 205-562-6903
Provider Business Practice Location Address
First Line : 2350 HARGROVE RD E
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35405-2612
Country : US
Telephone Number : 205-562-7002
Fax Number : 205-562-6903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 08/13/2012

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