Provider Demographics
NPI:1114230638
Name:CRAWFORD, JAMES HULLON (RDMS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HULLON
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 WARRIORS TRL
Mailing Address - Street 2:#5
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-7207
Mailing Address - Country:US
Mailing Address - Phone:760-669-9602
Mailing Address - Fax:
Practice Address - Street 1:2505 WARRIORS TRL
Practice Address - Street 2:#5
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-7207
Practice Address - Country:US
Practice Address - Phone:760-669-9602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN071452471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography