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Mark K Crawford

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NPI Number Detailed Information

Provider Information:

Name: Mark K Crawford
Gender: M
Provider License Number If Given: 93-29

NPI Information:

NPI: 1619970654
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 3/12/2019

Provider Business Mailing Address:

Address: PO BOX 26028
Albuquerque, NM 87125
Phone Number: 5052627215
Fax Number: 5052321627

Provider Business Practice Location Address:

Address: 2901 TRANSPORT ST SE
Albuquerque, NM 87106
Phone Number: 5052620050
Fax Number: 5052620019

Provider Taxonomy:

Primary: 207LP2900X
Secondary (if any): 207XS0117X
State: NM

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