Individual
DR. PHILIP EDWIN CRANSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2538
(601) 815-1854
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
05972
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124000
—
MS
01
—
300071336
RAILROAD MEDICARE
MS
01
—
512G700003
MS MEDICARE - GROUP
MS
01
—
P00462179
RAILROAD MEDICARE
MS
01
—
P01198271
RAILROAD MEDICARE PTAN
MS
Enumeration date
06/18/2006
Last updated
09/10/2013
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