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NPI Code Detail

MEDICARE: DOMENIC CRANER MD

MEDICARE: DOMENIC CRANER 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
12084N0400XNeurology Physician56938KY
2390200000XStudent in an Organized Health Care Education/Training ProgramTN
3208600000XSurgery PhysicianTP898KY

General Provider Information

NPI Number : 1861923914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMENIC CRANER MD
Provider Business Mailing Address
First Line : 3 AUDUBON PLAZA DR STE 230
Second Line :
City : LOUISVILLE
State : KY
Zip : 40217-1319
Country : US
Telephone Number : 502-637-3311
Fax Number : 502-637-3168
Provider Business Practice Location Address
First Line : 3 AUDUBON PLAZA DR STE LL2
Second Line :
City : LOUISVILLE
State : KY
Zip : 40217-1360
Country : US
Telephone Number : 502-636-4940
Fax Number : 502-636-4941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 12/29/2023

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Directions to “ DOMENIC CRANER MD” Practice Location

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