Healthcare Provider Details

I. General information

NPI: 1588740575
Provider Name (Legal Business Name): JAMES PARKER CREWS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 NORTH DIXIE HWY.
CAVE CITY KY
42127-9605
US

IV. Provider business mailing address

P.O. BOX 486
CAVE CITY KY
42127-9605
US

V. Phone/Fax

Practice location:
  • Phone: 270-773-3736
  • Fax: 270-773-2363
Mailing address:
  • Phone: 270-773-3736
  • Fax: 270-773-2363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15274
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: