Crandall, Wallace Vernon

Crandall, Wallace Vernon is an individual health care provider with primary practice located at 700 Children'S Drive , Columbus OH 43205-2664. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Crandall, Wallace Vernon can be contacted via phone (614) 722-3450.

Contact Information

Primary practice address
700 Children'S Drive Columbus OH 43205-2664
Phone: (614) 722-3450
Fax: (614) 722-3454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 35-078095 Ohio

Profile Details

NPI number 1932108123
LBN Legal business name Crandall, Wallace Vernon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Jan 27th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932108123 NPPES
Ohio MEDICAID 2196869
Ohio MEDICAID 6402137100

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