Provider Demographics
NPI:1154382596
Name:CRAWFORD, JOHN TED (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TED
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:13101 N ORACLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-9559
Mailing Address - Country:US
Mailing Address - Phone:520-825-0300
Mailing Address - Fax:520-825-0047
Practice Address - Street 1:13101 N ORACLE RD STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9559
Practice Address - Country:US
Practice Address - Phone:520-825-0300
Practice Address - Fax:520-825-0047
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ2455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZFQ61788OtherMEDICARE
AZFQ031815OtherMEDICARE
AZFQ031813OtherMEDICARE
AZFQ031820OtherMEDICARE
AZFQ031814OtherMEDICARE
AZFQ61788OtherMEDICARE
AZFQ031814OtherMEDICARE