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NPI 1154813012

NPI 1154813012 : MR. CURTIS LEE CREWS JR. : BRUNSWICK, GA

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General NPI Number Information
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    NPI Number           |    1154813012
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    Entity Type          |    Individual 
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    Provider Name        |    MR. CURTIS LEE CREWS JR.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/05/2018
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    Last Update Date     |    06/05/2018
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Provider Practice Location Address
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    Address Line         |    38 CRABAPPLE LN 
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    City                 |    BRUNSWICK
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    State                |    GA
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    Zip                  |    31523
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    Country              |    US
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    Telephone            |    904-703-8832
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2073 
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    City                 |    BRUNSWICK
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    State                |    GA
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    Zip                  |    31521-2073
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    Country              |    US
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    Telephone            |    904-703-8832
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    GA
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