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General NPI Number Information
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NPI Number | 1124215645
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Entity Type | Organization
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Legal Business Name | JASON CRAWFORD, O.D., PA
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 9710 SAM FURR RD UNIT A
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4928
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Country | US
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Telephone | 901-212-7876
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Fax |
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Provider Business Mailing Address
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Address Line | 9710 SAM FURR RD UNIT A
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4928
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Country | US
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Telephone | 901-212-7876
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | DR. JASON CRAWFORD
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Credential | O.D.
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Telephone | 901-212-7876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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