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General NPI Number Information
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NPI Number | 1295808178
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Entity Type | Organization
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Legal Business Name | CRAWFORD RADIOLOGY LTD
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 1000 N ALLEN ST DEPT OF RADIOLOGY
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City | ROBINSON
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State | IL
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Zip | 62454
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Country | US
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Telephone | 616-544-3131
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 790126 DEPT 30660
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City | SAINT LOUIS
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State | MO
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Zip | 63179-0126
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Country | US
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Telephone | 866-331-7699
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANDRA S KNUTH
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Credential | DO
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Telephone | 616-544-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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