Individual
MR. CRANFORD RICHARD POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2555 KENTUCKY AVE, INDIANAPOLIS, IN 46221-5004
(317) 481-6626
(317) 481-6629
Mailing address
1155 THICKET CT APT A, COLUMBUS, IN 47201-9700
(812) 343-5512
(317) 481-6629
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001530A
IN
363AM0700X
Medical Physician Assistant
PA000033-46
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001530A
PA
IN
01
—
PA000033-46
PA
FL
Enumeration date
10/17/2006
Last updated
07/01/2021
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