Healthcare Provider Details

I. General information

NPI: 1295921310
Provider Name (Legal Business Name): KEVIN T CRAWFORD DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31535 FORD RD
GARDEN CITY MI
48135-1821
US

IV. Provider business mailing address

31535 FORD RD
GARDEN CITY MI
48135-1821
US

V. Phone/Fax

Practice location:
  • Phone: 734-721-8785
  • Fax: 734-721-2938
Mailing address:
  • Phone: 734-721-8785
  • Fax: 734-721-2938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN T CRAWFORD
Title or Position: OWNER
Credential: DO
Phone: 734-721-8785