Healthcare Provider Details

I. General information

NPI: 1841278520
Provider Name (Legal Business Name): JANET LARD CROMWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 ENOCH BLVD
SAVANNAH TN
38372-2240
US

IV. Provider business mailing address

195 ENOCH BLVD
SAVANNAH TN
38372-2240
US

V. Phone/Fax

Practice location:
  • Phone: 731-926-1502
  • Fax: 731-926-4062
Mailing address:
  • Phone: 731-926-1502
  • Fax: 731-926-4062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15250
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: