Provider Demographics
NPI:1477541407
Name:CROFT, WILLIAM V (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:V
Last Name:CROFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2585 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150
Mailing Address - Country:US
Mailing Address - Phone:812-944-8451
Mailing Address - Fax:812-949-2356
Practice Address - Street 1:2585 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150
Practice Address - Country:US
Practice Address - Phone:812-944-8451
Practice Address - Fax:812-949-2356
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01024946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100115480AMedicaid
000000379521OtherANTHEM
IN100115480AMedicaid
IN170470EMedicare PIN