Healthcare Provider Details

I. General information

NPI: 1144488891
Provider Name (Legal Business Name): GEORGE I CRAWFORD JR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 WOODSTOCK AVE
ANNISTON AL
36207-4708
US

IV. Provider business mailing address

1105 WOODSTOCK AVE
ANNISTON AL
36207-4708
US

V. Phone/Fax

Practice location:
  • Phone: 256-240-7272
  • Fax: 256-240-7242
Mailing address:
  • Phone: 256-240-7272
  • Fax: 256-240-7242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberMD.26618
License Number StateAL

VIII. Authorized Official

Name: DR. GEORGE I. CRAWFORD JR.
Title or Position: MD
Credential: MD PC
Phone: 256-240-7272