Healthcare Provider Details

I. General information

NPI: 1811978281
Provider Name (Legal Business Name): JOHN T CRANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BOISE AVE STE 410
LOVELAND CO
80538-5004
US

IV. Provider business mailing address

1900 BOISE AVE STE 410
LOVELAND CO
80538-5004
US

V. Phone/Fax

Practice location:
  • Phone: 970-820-2610
  • Fax: 970-820-2611
Mailing address:
  • Phone: 970-820-2610
  • Fax: 970-820-2611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number33354
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0033354
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: