Provider Demographics
NPI:1235304072
Name:CRAWFORD, JESS HUNLEY III (DC)
Entity Type:Individual
Prefix:DR
First Name:JESS
Middle Name:HUNLEY
Last Name:CRAWFORD
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 CHANDLER CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2800
Mailing Address - Country:US
Mailing Address - Phone:301-638-4300
Mailing Address - Fax:301-638-1090
Practice Address - Street 1:975 CHANDLER CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2800
Practice Address - Country:US
Practice Address - Phone:301-638-4300
Practice Address - Fax:301-638-1090
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
672764Medicare UPIN