MEDICARE: TIMOTH B. CRANE, M.D., INC.

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
1	207W00000X	Ophthalmology Physician	04268	HI

General Provider Information

NPI Number	:	1942378989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTH B. CRANE, M.D., INC.

Provider Business Mailing Address
First Line	:	4463 PAHEE ST
Second Line	:	SUITE #206
City	:	LIHUE
State	:	HI
Zip	:	96766-2000
Country	:	US
Telephone Number	:	808-246-0110
Fax Number	:

Provider Business Practice Location Address
First Line	:	4463 PAHEE ST
Second Line	:	SUITE #206
City	:	LIHUE
State	:	HI
Zip	:	96766-2000
Country	:	US
Telephone Number	:	808-246-0110
Fax Number	:

Authorized Official
Title or Position	:	OPHTHALMOLOGIST
Name	:	TIMOTHY B. CRANE
Credential	:	M.D.
Telephone Number	:	808-246-0110

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/22/2020

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