Crain, Jack Lee

Crain, Jack Lee is an individual health care provider with primary practice located at 1524 E Morehead St , Charlotte NC 28207-1606. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Crain, Jack Lee can be contacted via phone (704) 343-4452.

Contact Information

Primary practice address
1524 E Morehead St Charlotte NC 28207-1606
Phone: (704) 343-4452
Fax: (704) 343-3428
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X North Carolina

Profile Details

NPI number 1073583555
LBN Legal business name Crain, Jack Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073583555 NPPES
North Carolina Other 200001202683 PHYS PRIVILEGE LICENSE
North Carolina Other 28480 PHYS PRIVILEGE LICENSE

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