Provider Demographics
NPI:1659614733
Name:CRAYNE, COURTNEY BLAKE (MD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:BLAKE
Last Name:CRAYNE
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 1:1976 GADSDEN HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3246
Mailing Address - Country:US
Mailing Address - Phone:205-508-3982
Mailing Address - Fax:205-508-3983
Practice Address - Street 1:1976 GADSDEN HWY STE 105
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3246
Practice Address - Country:US
Practice Address - Phone:205-508-3982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.35122208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics