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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295726867 NPPES
Georgia Other 552328 BLUE CROSS
Georgia MEDICAID 00677201A BLUE CROSS

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