Provider Demographics
NPI:1225016264
Name:CRANSTON, STEPHEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:CRANSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-1330
Mailing Address - Country:US
Mailing Address - Phone:316-283-6964
Mailing Address - Fax:
Practice Address - Street 1:700 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9013
Practice Address - Country:US
Practice Address - Phone:316-283-0027
Practice Address - Fax:316-283-2968
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-15700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1225016264OtherMEDICARE INDIVIDUAL NPI
KS100102820AMedicaid
KS1871588533OtherNEWTON HEALTHCARE CORPORATION GROUP NPI
KS016320Medicare ID - Type UnspecifiedMEDICARE NUMBER
KSB90987Medicare UPIN