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General NPI Number Information
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NPI Number | 1467554618
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Entity Type | Individual
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Provider Name | JEFFREY WYATT CROOMS MD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 4250 HOSPITAL DR
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City | MARIANNA
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State | FL
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Zip | 32446-1917
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Country | US
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Telephone | 850-526-2200
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Fax | 850-718-2844
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Provider Business Mailing Address
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Address Line | 1405 CENTERVILLE RD SUITE 4400
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4655
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Country | US
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Telephone | 850-877-6212
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Fax | 850-878-4034
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME0043049
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License Number State | FL
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