MEDICARE: JAMES LUTHER CRABB 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	207P00000X	Emergency Medicine Physician	07971	TN
2	207Q00000X	Family Medicine Physician	MD7971	TN
3	207W00000X	Ophthalmology Physician	MD7971	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00233179	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4175853	OTHER	TN	BCBS
3	4108241	OTHER	TN	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922047489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES LUTHER CRABB MD

Provider Business Mailing Address
First Line	:	36 NORTHWOOD AVE
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-4450
Country	:	US
Telephone Number	:	731-394-4596
Fax Number	:

Provider Business Practice Location Address
First Line	:	176 W UNIVERSITY PKWY STE C
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-1618
Country	:	US
Telephone Number	:	731-660-6915
Fax Number	:	731-668-4557

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	09/05/2013

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Directions to “ JAMES LUTHER CRABB MD” Practice Location

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