Individual provider · Type 1 NPI
Keith Robert Crandall, DPM
Foot & Ankle Surgery Podiatrist · Tyler, TX
NPI number
1104125780
Active
Practice location
1605 Stafford Dr
Tyler, TX 75703-0839
Fax (888) 503-2519
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | BN6420119-057356 (OH) |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 2066 (TX) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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About NPI 1104125780
Keith Robert Crandall, DPM's National Provider Identifier is 1104125780, issued on Mar 21, 2011. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Tyler, TX. The record was last updated on Jul 5, 2022.