Individual
DR. TRAVES DEAN CRABTREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
315 W CARPENTER ST, 2ND FLOOR CLINIC C, SPRINGFIELD, IL 62702-4901
(217) 545-8000
(217) 545-7053
Mailing address
315 W CARPENTER ST, PO BOX 19677, SPRINGFIELD, IL 62794-9677
(217) 545-8000
(217) 545-7053
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036112228
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
919620412
—
MO
Enumeration date
07/18/2006
Last updated
10/21/2020
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