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Contact Information

GARY CRANDELL, PA
12 HOPE DR
BAGDAD, AZ86321
 Phone: 928-633-4111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for GARY CRANDELL · (Male)

NPI Number 1528087251
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 07/19/2006
Last updated 09/02/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 2203
  • AZ Medicaid 567753
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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