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General NPI Number Information
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NPI Number | 1922089390
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Entity Type | Individual
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Provider Name | W. DON CRASKE III DO
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 335 GLESSNER AVE
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City | MANSFIELD
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State | OH
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Zip | 44903-2269
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Country | US
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Telephone | 419-524-8151
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Fax | 419-524-1747
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone |
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 34-00-4251-C
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License Number State | OH
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