Provider Demographics
NPI:1144488891
Name:GEORGE I CRAWFORD JR MD PC
Entity type:Organization
Organization Name:GEORGE I CRAWFORD JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD PC
Authorized Official - Phone:256-240-7272
Mailing Address - Street 1:1105 WOODSTOCK AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4708
Mailing Address - Country:US
Mailing Address - Phone:256-240-7272
Mailing Address - Fax:256-240-7242
Practice Address - Street 1:1105 WOODSTOCK AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4708
Practice Address - Country:US
Practice Address - Phone:256-240-7272
Practice Address - Fax:256-240-7242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.26618261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51546777OtherBCBS
AL101242Medicaid
AL51546777OtherBCBS