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NPI Code Detail

MEDICARE: CRANE EMERGENCY PHYSICIANS

MEDICARE: CRANE EMERGENCY PHYSICIANS
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
198701OTHERFLBLUE SHIELD

General Provider Information

NPI Number : 1467401380
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRANE EMERGENCY PHYSICIANS
Provider Business Mailing Address
First Line : PO BOX 13378
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-3378
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 159 N 3RD ST
Second Line :
City : MACCLENNY
State : FL
Zip : 32063-2103
Country : US
Telephone Number : 904-259-3151
Fax Number : 904-259-3160
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSEPH H. GATEWOOD
Credential :
Telephone Number : 214-712-2000
Provider Enumeration Date : 05/08/2006
Last Update Date : 04/20/2008

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Directions to “CRANE EMERGENCY PHYSICIANS ” Practice Location

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