| Brent Crane Md Llc | |
|
200 N Main St Haviland KS 67059-9525 | |
| (937) 367-6496 | |
| Not Available |
| Full Name | Brent Crane Md Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 200 N Main St, Haviland, Kansas |
| Authorized Official Name and Position | Brent A Crane (OWNER) |
| Authorized Official Contact | 9373676496 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Crane Md Llc 1324 Woodstock Dr Oakwood OH 45419-3033 Ph: (937) 367-6496 | Brent Crane Md Llc 200 N Main St Haviland KS 67059-9525 Ph: (937) 367-6496 |
| NPI Number | 1376163691 |
|---|---|
| Provider Enumeration Date | 04/17/2020 |
| Last Update Date | 07/13/2021 |
| Certification Date | 07/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376163691 | NPI | - | NPPES |
| KA4287013 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |