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NPI Code Detail

MEDICARE: JEFFREY J. CROWLEY, M.D., INC.

MEDICARE: JEFFREY J. CROWLEY, M.D., INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ND0101XMOHS-Micrographic Surgery PhysicianG77643CA
2207NP0225XPediatric Dermatology PhysicianA70557CA
3207N00000XDermatology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11073500278OTHERINDIVIDUAL NPI
21154366011OTHERINDIVIDUAL NPI
31306926456OTHERINDIVIDUAL NPI
41700895018OTHERINDIVIDUAL NPI

General Provider Information

NPI Number : 1538214804
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEFFREY J. CROWLEY, M.D., INC.
Provider Business Mailing Address
First Line : 5101 COMMERCE DR
Second Line : SUITE 101
City : BAKERSFIELD
State : CA
Zip : 93309-0411
Country : US
Telephone Number : 661-327-3756
Fax Number : 661-327-2332
Provider Business Practice Location Address
First Line : 5101 COMMERCE DR
Second Line : SUITE 101
City : BAKERSFIELD
State : CA
Zip : 93309-0411
Country : US
Telephone Number : 661-327-3756
Fax Number : 661-327-2332
Authorized Official
Title or Position : OFFICE MANAGER
Name : DEANNA JACOBS
Credential :
Telephone Number : 661-327-3756
Provider Enumeration Date : 01/24/2007
Last Update Date : 05/24/2023

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1427492586 — DR. MARK C PHILLIPS D.D.S.
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