Provider Demographics
NPI:1740636000
Name:CRAWFORD, REBEKAH H (DO)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:H
Last Name:CRAWFORD
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 COLUMBUS RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43019-1266
Mailing Address - Country:US
Mailing Address - Phone:740-694-1261
Mailing Address - Fax:740-694-7145
Practice Address - Street 1:122 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:OH
Practice Address - Zip Code:43019-1266
Practice Address - Country:US
Practice Address - Phone:740-694-1261
Practice Address - Fax:740-694-7145
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34014071207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0370762Medicaid