Provider Demographics
NPI:1861494676
Name:CRAN-CARTY, WENDY LEE (MD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:LEE
Last Name:CRAN-CARTY
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 1:1188 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-3206
Mailing Address - Country:US
Mailing Address - Phone:731-642-8883
Mailing Address - Fax:731-642-8997
Practice Address - Street 1:1188 N MARKET ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-3206
Practice Address - Country:US
Practice Address - Phone:731-642-8883
Practice Address - Fax:731-642-8997
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38803207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN32611Medicaid
TN4091523OtherTENNCARE
TN421640170OtherCHAMPUS TRICARE
TN3726534OtherTENNCARE/MEDICAID
TN421640170OtherOMNICARE
TN5222034OtherCIGNA HEALTHCARE
TN4091523OtherBLUECROSS BLUESHIELD
TN421640170OtherCOMMUNITY CHOICE NETWORK
TN421640170OtherHEALTH PARTNERS
TN158937OtherBETTER HEALTH PLANS
TN11340100OtherCAQH
TN11340100OtherCAQH
TN4091523OtherTENNCARE
TN421640170OtherCOMMUNITY CHOICE NETWORK