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NPI Code Detail

MEDICARE: DR. MARK CROWELL MD

MEDICARE: DR. MARK CROWELL MD
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
1207L00000XAnesthesiology Physician09224AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1515-00523OTHERALBCBS

General Provider Information

NPI Number : 1821025420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK CROWELL MD
Provider Business Mailing Address
First Line : PO BOX 1409
Second Line :
City : BAY MINETTE
State : AL
Zip : 36507-1409
Country : US
Telephone Number : 251-580-1752
Fax Number : 251-580-1733
Provider Business Practice Location Address
First Line : 1815 HAND AVE
Second Line :
City : BAY MINETTE
State : AL
Zip : 36507-4110
Country : US
Telephone Number : 251-580-1752
Fax Number : 251-580-1733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 07/08/2007

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