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NPI Code Detail

MEDICARE: JOSEPH PUTNAM CRAWFORD MD

MEDICARE: JOSEPH PUTNAM CRAWFORD MD
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
1208800000XUrology PhysicianME46397FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
231183OTHERFLBLUE CROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689661738
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH PUTNAM CRAWFORD MD
Provider Business Mailing Address
First Line : 1986 35TH AVE
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-2533
Country : US
Telephone Number : 772-562-7220
Fax Number : 772-562-5476
Provider Business Practice Location Address
First Line : 1986 35TH AVE
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-2533
Country : US
Telephone Number : 772-562-7220
Fax Number : 772-562-5476
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 09/05/2012

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