Healthcare Provider Details

I. General information

NPI: 1679556799
Provider Name (Legal Business Name): GILBERT K CRANE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 5TH ST N
BURLEY ID
83318-3453
US

IV. Provider business mailing address

1224 8TH ST
RUPERT ID
83350-1599
US

V. Phone/Fax

Practice location:
  • Phone: 208-678-9760
  • Fax: 208-678-9758
Mailing address:
  • Phone: 208-436-0481
  • Fax: 208-436-6038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberM5867
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: