Healthcare Provider Details

I. General information

NPI: 1609857614
Provider Name (Legal Business Name): STEVEN ALAN CREWS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 N GATEWAY AVE UNIT 2
HARRIMAN TN
37748-8709
US

IV. Provider business mailing address

129 BRADSHAW HOLLOW RD
ROCKWOOD TN
37854-4629
US

V. Phone/Fax

Practice location:
  • Phone: 658-822-0108
  • Fax: 865-882-0099
Mailing address:
  • Phone: 352-551-6237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS 0005959
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0000003650
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: