Provider Demographics
NPI:1376518845
Name:CRANLEY SURGICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:CRANLEY SURGICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PALATCHI
Authorized Official - Suffix:
Authorized Official - Credentials:EXECUTIVE DIRECTOR
Authorized Official - Phone:513-961-4335
Mailing Address - Street 1:3747 W FORK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7548
Mailing Address - Country:US
Mailing Address - Phone:513-961-4335
Mailing Address - Fax:513-961-4227
Practice Address - Street 1:3747 W FORK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-7548
Practice Address - Country:US
Practice Address - Phone:513-961-4335
Practice Address - Fax:513-961-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100056850Medicaid
OH0327917Medicaid
OH9264631OtherMEDICARE GROUP
OHCC1088Medicare PIN
KY7100056850Medicaid
OH9264631OtherMEDICARE GROUP
OH9264631Medicare PIN
KYDC8729Medicare PIN