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General NPI Number Information
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NPI Number | 1295993194
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Entity Type | Organization
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Legal Business Name | CRAWFORD PLASTIC SURGERY
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 3450 ACWORTH DUE WEST RD NW STE 220
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City | KENNESAW
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State | GA
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Zip | 30144-1001
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Country | US
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Telephone | 770-794-6643
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Fax | 770-618-9617
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Provider Business Mailing Address
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Address Line | 3450 ACWORTH DUE WEST RD NW STE 220
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City | KENNESAW
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State | GA
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Zip | 30144-1001
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Country | US
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Telephone | 770-794-6643
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Fax | 770-794-6683
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. MARCUS H CRAWFORD
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Credential | M.D.
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Telephone | 770-794-6643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 058734
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License Number State | GA
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