Provider Demographics
NPI:1902943814
Name:CRAN, PATRICIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:CRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W SAINT MARY BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4600
Mailing Address - Country:US
Mailing Address - Phone:337-593-9383
Mailing Address - Fax:337-593-9385
Practice Address - Street 1:501 W SAINT MARY BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4600
Practice Address - Country:US
Practice Address - Phone:337-593-9383
Practice Address - Fax:337-593-9385
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL017245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1360767Medicaid
LA51750Medicare ID - Type Unspecified
LA1360767Medicaid