Provider Demographics
NPI:1750445276
Name:CRAWFORD, STANLEY LUKE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:LUKE
Last Name:CRAWFORD
Suffix:JR
Gender:M
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:PO BOX 13013
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-0013
Mailing Address - Country:US
Mailing Address - Phone:501-831-4490
Mailing Address - Fax:501-851-0694
Practice Address - Street 1:11401 INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-7042
Practice Address - Country:US
Practice Address - Phone:501-831-4490
Practice Address - Fax:501-851-0694
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC72602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARF60266Medicare UPIN
AR5J145Medicare ID - Type Unspecified