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General NPI Number Information
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NPI Number | 1952305542
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Entity Type | Individual
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Provider Name | JOHN ARTHUR CRAYNE MD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 3415 STERNS RD.
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-9576
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Country | US
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Telephone | 734-847-0538
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Fax | 734-847-6669
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Provider Business Mailing Address
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Address Line | 3415 STERNS RD
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-9576
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Country | US
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Telephone | 734-847-0538
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Fax | 734-847-6669
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35045336
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License Number State | OH
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