Provider Demographics
NPI:1134194285
Name:CRANWELL, JOHN D (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:CRANWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 11589
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401
Mailing Address - Country:US
Mailing Address - Phone:423-778-3274
Mailing Address - Fax:423-778-7664
Practice Address - Street 1:2600 TAFT HIGHWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-2766
Practice Address - Country:US
Practice Address - Phone:423-778-9434
Practice Address - Fax:423-778-9433
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00085502OtherRAILROAD MEDICARE
TNP00085502OtherRAILROAD MEDICARE
TN3170380Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER