Provider Demographics
NPI:1255604799
Name:CRAWFORD, STEPHEN W (RPH)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 N 1150 RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:64128
Mailing Address - Country:US
Mailing Address - Phone:913-940-0338
Mailing Address - Fax:
Practice Address - Street 1:9350 MARSHALL DRIVE
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215
Practice Address - Country:US
Practice Address - Phone:913-227-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS09600183500000X
MO29229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist