Provider Demographics
NPI:1154526481
Name:STEPHEN D. CRANSTON, M.D.
Entity type:Organization
Organization Name:STEPHEN D. CRANSTON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRANSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-283-0027
Mailing Address - Street 1:1701 CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-1330
Mailing Address - Country:US
Mailing Address - Phone:316-283-6964
Mailing Address - Fax:
Practice Address - Street 1:700 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9013
Practice Address - Country:US
Practice Address - Phone:316-283-0027
Practice Address - Fax:316-283-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000366OtherBC INDIVIDUAL NUMBER
KS000366OtherBC INDIVIDUAL NUMBER
KSB90987Medicare UPIN