Healthcare Provider Details

I. General information

NPI: 1295412336
Provider Name (Legal Business Name): MADELINE J CRUMBLEY AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 SANDY SPRINGS CIR STE 185
SANDY SPRINGS GA
30328-3861
US

IV. Provider business mailing address

220 SANDY SPRINGS CIR STE 185
SANDY SPRINGS GA
30328-3861
US

V. Phone/Fax

Practice location:
  • Phone: 404-919-7219
  • Fax:
Mailing address:
  • Phone: 404-919-7219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD004374
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: