Provider Demographics
NPI:1679556799
Name:CRANE, GILBERT K (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:K
Last Name:CRANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1263 BENNETT AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-4906
Mailing Address - Country:US
Mailing Address - Phone:208-678-9760
Mailing Address - Fax:208-678-9758
Practice Address - Street 1:1263 BENNETT AVE
Practice Address - Street 2:STE 1
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-4906
Practice Address - Country:US
Practice Address - Phone:208-678-9760
Practice Address - Fax:208-678-9758
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM5867207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID003643700Medicaid
ID003643700Medicaid
IDF18307Medicare UPIN
ID1221010001Medicare NSC