Healthcare Provider Details

I. General information

NPI: 1154374957
Provider Name (Legal Business Name): JAMES HOLT CREWS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 11/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MARSHALL STREET SUITE 400
JACKSON MS
39202-1687
US

IV. Provider business mailing address

501 MARSHALL STREET SUITE 400
JACKSON MS
39202-1687
US

V. Phone/Fax

Practice location:
  • Phone: 601-354-0869
  • Fax: 601-352-6521
Mailing address:
  • Phone: 601-354-0869
  • Fax: 601-352-6521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number16530
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number16530
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: