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General NPI Number Information
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NPI Number | 1497885180
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Entity Type | Individual
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Provider Name | GUY ALVIN CRAWFORD PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 04/08/2010
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Provider Practice Location Address
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Address Line | 11111 HIGHWAY 98 EAST
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407
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Country | US
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Telephone | 850-236-8655
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Fax |
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Provider Business Mailing Address
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Address Line | 120 WOODLAWN DR
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-5449
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Country | US
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Telephone | 850-234-9216
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 2457
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License Number State | FL
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