Provider Demographics
NPI:1265570808
Name:CRAWFORD, CHARLES HOPKINS III (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HOPKINS
Last Name:CRAWFORD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:210 E GRAY ST
Practice Address - Street 2:SUITE 900
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3900
Practice Address - Country:US
Practice Address - Phone:502-584-8002
Practice Address - Fax:502-589-0849
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2008004916207XS0117X
KYR0688207XS0117X
KYTP699207XS0117X
KY43066207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000628568OtherNLS/ANTHEM
7157066OtherNLSC/CIGNA
50026895OtherNLSC/PHP
3754853000OtherNLSC/PAD
000051983KOtherNLSC/HUMANA
109190OtherNLSC/SIHO
KY7100238200Medicaid
IN200951090Medicaid
000051983KOtherNLSC/HUMANA