Provider Demographics
NPI:1952743213
Name:CRAWFORD SURGICAL FIRST ASSISTING LLC
Entity Type:Organization
Organization Name:CRAWFORD SURGICAL FIRST ASSISTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRISTOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-449-3487
Mailing Address - Street 1:2450 N WILLOW RANCH RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-6705
Mailing Address - Country:US
Mailing Address - Phone:520-449-3487
Mailing Address - Fax:520-203-8290
Practice Address - Street 1:2450 N WILLOW RANCH RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-6705
Practice Address - Country:US
Practice Address - Phone:520-449-3487
Practice Address - Fax:520-203-8290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-26
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3152364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1467691287OtherINDIVIDUAL NPI