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Individual

ALAN E CRANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1498
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CS46489
STATE
ID
01
PA-1498
STATE
ID
Enumeration date
09/19/2017
Last updated
10/21/2025
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