Provider Demographics
NPI:1407972060
Name:CRABTREE, GARRETT M (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:M
Last Name:CRABTREE
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 1:2005 LAKE POINT WAY
Mailing Address - Street 2:STE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4236
Mailing Address - Country:US
Mailing Address - Phone:502-327-0331
Mailing Address - Fax:
Practice Address - Street 1:2005 LAKE POINT WAY
Practice Address - Street 2:STE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4236
Practice Address - Country:US
Practice Address - Phone:502-327-0331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19567207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology