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General NPI Number Information
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NPI Number | 1801413141
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Entity Type | Individual
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Provider Name | DAVID CRANFORD C.PED CPOA CTPO CFO
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Gender | Male
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 6515 POPLAR AVE STE 112
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City | MEMPHIS
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State | TN
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Zip | 38119-4878
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Country | US
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Telephone | 901-795-1776
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Fax | 901-795-1738
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Provider Business Mailing Address
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Address Line | 9537 CHI CHI CV
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City | LAKELAND
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State | TN
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Zip | 38002-4289
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Country | US
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Telephone | 901-586-5010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224L00000X
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Taxonomy Name | Pedorthist
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License Number | PED0126
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License Number State | TN
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