Healthcare Provider Details

I. General information

NPI: 1225665474
Provider Name (Legal Business Name): ISAAC DUSHANE CRAWFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 PRYTANIA ST STE 460
NEW ORLEANS LA
70115-3579
US

IV. Provider business mailing address

719 PLEASANT ST
NEW ORLEANS LA
70115-1119
US

V. Phone/Fax

Practice location:
  • Phone: 504-897-7999
  • Fax: 504-897-7876
Mailing address:
  • Phone: 504-427-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number334883
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: