Crews, Jack
Crews, Jack is an individual health care provider with primary practice located at 100 Professional Pl Suite 204, Carrollton GA 30117-3874. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Crews, Jack can be contacted via phone (770) 384-3351.Contact Information
Primary practice address
100 Professional Pl Suite 204
Carrollton GA 30117-3874
Phone: (770) 384-3351
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 010514 | Georgia |
Profile Details
| NPI number | 1295726867 |
|---|---|
| LBN Legal business name | Crews, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Jul 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295726867 | NPPES |
| Georgia | Other | 552328 | BLUE CROSS |
| Georgia | MEDICAID | 00677201A | BLUE CROSS |
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