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NPI Code Detail

MEDICARE: LEE R CROWE M.D.

MEDICARE:   LEE R CROWE  M.D.
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
1207RN0300XNephrology Physician7522TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24212675OTHERTNBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629062740
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE R CROWE M.D.
Provider Business Mailing Address
First Line : 127 N OAK AVE
Second Line : SUITE D
City : COOKEVILLE
State : TN
Zip : 38501-2435
Country : US
Telephone Number : 931-783-5857
Fax Number : 931-526-6760
Provider Business Practice Location Address
First Line : 145 W 4TH ST
Second Line : SUITE 201
City : COOKEVILLE
State : TN
Zip : 38501-2447
Country : US
Telephone Number : 931-783-2902
Fax Number : 931-783-2219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 05/15/2017

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Directions to “ LEE R CROWE M.D.” Practice Location

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