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NPI Code Detail

MEDICARE: DR. CAROLYN ANN CRUVANT M.D.

MEDICARE: DR. CAROLYN ANN CRUVANT 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
1207W00000XOphthalmology Physician5853NV

Other Identifiers

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

General Provider Information

NPI Number : 1942291448
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROLYN ANN CRUVANT M.D.
Provider Business Mailing Address
First Line : 50 S STEPHANIE ST STE 101
Second Line :
City : HENDERSON
State : NV
Zip : 89012-5731
Country : US
Telephone Number : 702-202-4776
Fax Number : 702-202-6110
Provider Business Practice Location Address
First Line : 3575 PECOS MCLEOD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3803
Country : US
Telephone Number : 702-731-2088
Fax Number : 702-734-7836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 03/29/2023

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Directions to “ DR. CAROLYN ANN CRUVANT M.D.” Practice Location

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