Healthcare Provider Details

I. General information

NPI: 1659370252
Provider Name (Legal Business Name): JOHN CROMARTIE CRAWLEY PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 MEDICAL PARK AVE
NEW BERN NC
28562-5248
US

IV. Provider business mailing address

PO BOX 12248
NEW BERN NC
28561-2248
US

V. Phone/Fax

Practice location:
  • Phone: 252-514-2061
  • Fax:
Mailing address:
  • Phone: 252-447-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number100548
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number100548
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: