Provider Demographics
NPI:1740415736
Name:TOTTEN, CRYSTAL FAUN (MD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:FAUN
Last Name:TOTTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WARDER ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2581
Mailing Address - Country:US
Mailing Address - Phone:937-521-4823
Mailing Address - Fax:937-521-4825
Practice Address - Street 1:30 WARDER ST STE 220
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2581
Practice Address - Country:US
Practice Address - Phone:937-521-4823
Practice Address - Fax:937-521-4825
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47993208600000X
OH35120102208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery