Healthcare Provider Details

I. General information

NPI: 1538214804
Provider Name (Legal Business Name): JEFFREY J. CROWLEY, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 COMMERCE DR SUITE 101
BAKERSFIELD CA
93309-0411
US

IV. Provider business mailing address

5101 COMMERCE DR SUITE 101
BAKERSFIELD CA
93309-0411
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-3756
  • Fax: 661-327-2332
Mailing address:
  • Phone: 661-327-3756
  • Fax: 661-327-2332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberG77643
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License NumberA70557
License Number StateCA

VIII. Authorized Official

Name: DEANNA JACOBS
Title or Position: OFFICE MANAGER
Credential:
Phone: 661-327-3756