MEDICARE: DR. JOHN D. CRANWELL 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	207R00000X	Internal Medicine Physician	9391	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00085502	OTHER	TN	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1134194285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN D. CRANWELL M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 11589
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37401
Country	:	US
Telephone Number	:	423-778-3274
Fax Number	:	423-778-7664

Provider Business Practice Location Address
First Line	:	2600 TAFT HIGHWAY
Second Line	:	SUITE 100
City	:	SIGNAL MOUNTAIN
State	:	TN
Zip	:	37377-2766
Country	:	US
Telephone Number	:	423-778-9434
Fax Number	:	423-778-9433

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/17/2013

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