=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124022777
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES P CRANLEY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2005
-----------------------------------------------------
Last Update Date | 09/06/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4746 MONTGOMERY RD SUITE 202
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45212-2622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-233-4100
-----------------------------------------------------
Fax | 513-751-2267
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 632958
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45263-2958
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-451-9698
-----------------------------------------------------
Fax | 513-451-9412
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 35-046570
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------