Provider Demographics
NPI:1770570384
Name:CRAWFORD, CANDACE SUZANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:SUZANNE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 OUACHITA 67
Mailing Address - Street 2:
Mailing Address - City:LOUANN
Mailing Address - State:AR
Mailing Address - Zip Code:71751-8628
Mailing Address - Country:US
Mailing Address - Phone:870-725-3059
Mailing Address - Fax:
Practice Address - Street 1:220 S WEST AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-5934
Practice Address - Country:US
Practice Address - Phone:870-863-7996
Practice Address - Fax:870-863-4045
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist