Provider Demographics
NPI:1649532912
Name:CRANFORD, CARLTON CRAIG (DPM)
Entity type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:CRAIG
Last Name:CRANFORD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 8TH AVE W STE 101
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-845-4905
Mailing Address - Fax:888-491-5615
Practice Address - Street 1:300 RIVERSIDE DR E STE 1500
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1031
Practice Address - Country:US
Practice Address - Phone:941-741-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPM.200046213ES0103X
TX2049213ES0103X
FLPO4266213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX293340YSYFMedicare PIN