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General NPI Number Information
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NPI Number | 1750465126
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Entity Type | Organization
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Legal Business Name | COLIE E CRUTCHER MD
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 754 DERBY DR
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City | YORK
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State | AL
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Zip | 36925-2122
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Country | US
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Telephone | 205-392-5350
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Fax | 205-392-4821
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Provider Business Mailing Address
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Address Line | 754 DERBY DR
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City | YORK
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State | AL
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Zip | 36925-2122
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Country | US
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Telephone | 205-392-5350
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Fax | 205-392-4821
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. GLADYS B EDDIE
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Credential |
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Telephone | 205-392-5350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17070
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License Number State | AL
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