Provider Demographics
NPI:1699019729
Name:CRAWFORD, JOE DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:DEAN
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOEDEAN
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 64668
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-7068
Mailing Address - Country:US
Mailing Address - Phone:585-298-4958
Mailing Address - Fax:
Practice Address - Street 1:1485 HOWARD ROAD
Practice Address - Street 2:SUITE 64668
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-4176
Practice Address - Country:US
Practice Address - Phone:585-748-8525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267485207Q00000X, 207QA0401X
NC23869207Q00000X
TN13071207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine