Provider Demographics
NPI:1679556799
Name:CRANE, GILBERT K (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:K
Last Name:CRANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RUPERT
Mailing Address - State:ID
Mailing Address - Zip Code:83350-1599
Mailing Address - Country:US
Mailing Address - Phone:208-436-0481
Mailing Address - Fax:208-436-6038
Practice Address - Street 1:260 E 5TH ST N
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-3453
Practice Address - Country:US
Practice Address - Phone:208-678-9760
Practice Address - Fax:208-678-9758
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM5867207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID003643700Medicaid
ID003643700Medicaid
IDF18307Medicare UPIN
ID1221010001Medicare NSC