Provider Demographics
NPI:1487719324
Name:CRAWFORDSVILLE PEDIATRIC CENTER
Entity type:Organization
Organization Name:CRAWFORDSVILLE PEDIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-361-3086
Mailing Address - Street 1:1901 LAFAYETTE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-1098
Mailing Address - Country:US
Mailing Address - Phone:765-361-3086
Mailing Address - Fax:765-361-3088
Practice Address - Street 1:1901 LAFAYETTE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1098
Practice Address - Country:US
Practice Address - Phone:765-361-3086
Practice Address - Fax:765-361-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty