Provider Demographics
NPI:1497808455
Name:DANIEL C. CRAWFORD, O.D., P.C.
Entity Type:Organization
Organization Name:DANIEL C. CRAWFORD, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-423-8545
Mailing Address - Street 1:7760 W 38TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6136
Mailing Address - Country:US
Mailing Address - Phone:303-423-8545
Mailing Address - Fax:303-423-5084
Practice Address - Street 1:7760 W 38TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6136
Practice Address - Country:US
Practice Address - Phone:303-423-8545
Practice Address - Fax:303-423-5084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1742152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC44333Medicare PIN
COU52251Medicare UPIN