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NPI Code Detail

MEDICARE: CHRISTIAN T CRAWFORD PAC

MEDICARE: CHRISTIAN T CRAWFORD PAC
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
1363A00000XPhysician AssistantPA1361NV
2363A00000XPhysician AssistantPA-1181ID

General Provider Information

NPI Number : 1427303478
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN T CRAWFORD PAC
Provider Business Mailing Address
First Line : PO BOX 191050
Second Line :
City : BOISE
State : ID
Zip : 83719-1050
Country : US
Telephone Number : 208-955-6522
Fax Number : 208-955-6503
Provider Business Practice Location Address
First Line : 1375 N HAPPY VALLEY RD
Second Line :
City : NAMPA
State : ID
Zip : 83687-5280
Country : US
Telephone Number : 208-809-2869
Fax Number : 208-809-2870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2012
Last Update Date : 03/04/2025

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Directions to “ CHRISTIAN T CRAWFORD PAC” Practice Location

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