MEDICARE: DR. JULIE QUINN CRAWFORD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	33500	AZ
2	207R00000X	Internal Medicine Physician	33500	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104879303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE QUINN CRAWFORD M.D.

Provider Business Mailing Address
First Line	:	3200 E CAMELBACK RD
Second Line	:	STE 250
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2327
Country	:	US
Telephone Number	:	602-933-1814
Fax Number	:

Provider Business Practice Location Address
First Line	:	14541 W INDIAN SCHOOL ROAD
Second Line	:	STE 600
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-9243
Country	:	US
Telephone Number	:	623-535-5599
Fax Number	:	623-535-4696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	11/07/2019

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