Provider Demographics
NPI:1366607582
Name:CRALL, HAROLD DOUGLASS (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:DOUGLASS
Last Name:CRALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:ROEDERER CORRECTIONAL COMPLEX
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-0069
Mailing Address - Country:US
Mailing Address - Phone:502-222-0173
Mailing Address - Fax:
Practice Address - Street 1:4000 MORGAN RD
Practice Address - Street 2:ROEDERER CORRECTIONAL COMPLEX
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-0069
Practice Address - Country:US
Practice Address - Phone:502-222-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY27106207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine