MEDICARE: WILLIAMS SPENCE CREWS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	1063909497	MS
2	2085R0202X	Diagnostic Radiology Physician	351845	LA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	2085R0202X	Diagnostic Radiology Physician	26919	MS

General Provider Information

NPI Number	:	1063909497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAMS SPENCE CREWS MD

Provider Business Mailing Address
First Line	:	2500 N STATE ST
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4500
Country	:	US
Telephone Number	:	601-984-5604
Fax Number	:	601-984-6665

Provider Business Practice Location Address
First Line	:	2500 N STATE ST
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216
Country	:	US
Telephone Number	:	601-984-5604
Fax Number	:	601-984-6665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2018
Last Update Date	:	06/01/2026

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Directions to “ WILLIAMS SPENCE CREWS MD” Practice Location

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