Healthcare Provider Details

I. General information

NPI: 1033216130
Provider Name (Legal Business Name): ALAN J CROPP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 TRAILWOOD DR BOX 14130
YOUNGSTOWN OH
44512-5008
US

IV. Provider business mailing address

925 TRAILWOOD DR BOX 14130
YOUNGSTOWN OH
44512-5008
US

V. Phone/Fax

Practice location:
  • Phone: 330-758-7575
  • Fax: 330-758-1833
Mailing address:
  • Phone: 330-758-7575
  • Fax: 330-758-1833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35046185
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35046185
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: