Provider Demographics
NPI:1457347270
Name:CRANKSHAW, JOHN (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:CRANKSHAW
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 1:1958 E US HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-9799
Mailing Address - Country:US
Mailing Address - Phone:937-652-1834
Mailing Address - Fax:
Practice Address - Street 1:1958 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-9799
Practice Address - Country:US
Practice Address - Phone:937-652-1834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI37186Medicare UPIN
OHCR4165691Medicare ID - Type Unspecified