Provider Demographics
NPI:1982857264
Name:CRABILL, BRIAN A (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:CRABILL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:604-793-5132
Mailing Address - Fax:
Practice Address - Street 1:2101 DUBOIS DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3210
Practice Address - Country:US
Practice Address - Phone:574-372-7838
Practice Address - Fax:574-372-3848
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10002352A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant