Healthcare Provider Details

I. General information

NPI: 1174678577
Provider Name (Legal Business Name): DANIEL WAYNE CRAWFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2359 22ND DRIVE # 2
YUMA AZ
85364
US

IV. Provider business mailing address

2359 22ND DRIVE # 2
YUMA AZ
85364
US

V. Phone/Fax

Practice location:
  • Phone: 928-344-4800
  • Fax: 928-726-2377
Mailing address:
  • Phone: 928-344-4800
  • Fax: 928-726-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11838
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: