Provider Demographics
NPI:1760420236
Name:CRANE, JOSEPH THOMPSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMPSON
Last Name:CRANE
Suffix:
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 1:9423 GROUNDHOG DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3911
Mailing Address - Country:US
Mailing Address - Phone:540-287-4186
Mailing Address - Fax:
Practice Address - Street 1:1613 HARRISON PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2896
Practice Address - Country:US
Practice Address - Phone:540-287-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101225442207P00000X
UT12963923-1205207P00000X
MT114999207P00000X
IDM-16812207P00000X
FLME124137207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00123397OtherRAILROAD
VA010059267Medicaid
VA00V858F01Medicare PIN
VA010059267Medicaid