MEDICARE: DR. JAMES RANDOLPH 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	0101033063	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	146534	OTHER	VA	SO. HEALTH
2	033551	OTHER	VA	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780689752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES RANDOLPH CREWS MD

Provider Business Mailing Address
First Line	:	204 E WASHINGTON ST
Second Line	:
City	:	LEXINGTON
State	:	VA
Zip	:	24450-2718
Country	:	US
Telephone Number	:	540-463-5055
Fax Number	:	540-463-1079

Provider Business Practice Location Address
First Line	:	204 E WASHINGTON ST
Second Line	:
City	:	LEXINGTON
State	:	VA
Zip	:	24450-2718
Country	:	US
Telephone Number	:	540-463-5055
Fax Number	:	540-463-1079

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	05/15/2008

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