Basic Information
| Provider Information | |||||||||
| NPI: | 1770724841 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRANE | ||||||||
| FirstName: | F. MICHAEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1515 N 400 E | ||||||||
| Address2: | 104 | ||||||||
| City: | LOGAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843417561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357556061 | ||||||||
| FaxNumber: | 4357556091 | ||||||||
| Practice Location | |||||||||
| Address1: | 1515 N 400 E | ||||||||
| Address2: | 104 | ||||||||
| City: | LOGAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843417561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357556061 | ||||||||
| FaxNumber: | 4357556091 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2009 | ||||||||
| LastUpdateDate: | 06/07/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 180115-1205 | UT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.