NPI 1265567804 · live from the CMS NPI Registry
Stacey Michelle Wallace Crawford, M.D.
Radiology, Diagnostic Radiology in Louisville, KY. National Provider Identifier 1265567804, active.
NPI record
| NPI | 1265567804 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 4004 Dupont Cir Ste 230, Louisville, KY 40207 |
| Practice phone | 502-893-1333 |
| Mailing address | 2700 Stanley Gault Pkwy Ste 129, Louisville, KY 40223 |
| Enumerated | February 23, 2007 |
| Last updated | September 26, 2019 |
| Sole proprietor | No |
| Other names | Stacey Wallace |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology primary | 2085R0202X | 44088 (KY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.