Provider Demographics
NPI:1417997396
Name:CRANE, JOHN L (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:L
Last Name:CRANE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5949 NIEMAN RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-2907
Mailing Address - Country:US
Mailing Address - Phone:913-631-6114
Mailing Address - Fax:913-631-5263
Practice Address - Street 1:5949 NIEMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2907
Practice Address - Country:US
Practice Address - Phone:913-631-6114
Practice Address - Fax:913-631-5263
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0423330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO18049061OtherBLUE SHIELD OF KC
080150739OtherMEDICARE RAILROAD
E66004Medicare UPIN
080150739OtherMEDICARE RAILROAD