Provider Demographics
NPI:1760979850
Name:CRAWFORD, ALYSON (MD)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALYSON
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:75 PRINGLE WAY STE 1002
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1475
Mailing Address - Country:US
Mailing Address - Phone:775-323-7500
Mailing Address - Fax:
Practice Address - Street 1:75 PRINGLE WAY STE 1002
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1475
Practice Address - Country:US
Practice Address - Phone:775-323-7500
Practice Address - Fax:775-789-9208
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19107208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program