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General NPI Number Information
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NPI Number | 1649209321
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Entity Type | Organization
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Legal Business Name | JACQUELINE S. CRAWFORD, MD, PLLC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 10800 PARKSIDE DR SUITE 203
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City | KNOXVILLE
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State | TN
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Zip | 37934-1922
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Country | US
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Telephone | 865-218-8333
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Fax | 865-218-6228
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Provider Business Mailing Address
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Address Line | 10800 PARKSIDE DR SUITE 203
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City | KNOXVILLE
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State | TN
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Zip | 37934-1922
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Country | US
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Telephone | 865-218-8333
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Fax | 865-218-6228
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JACQUELINE S CRAWFORD
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Credential | M.D.
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Telephone | 865-218-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 30506
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License Number State | TN
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