Provider Demographics
NPI:1285645515
Name:CRUM,STEFANKO AND JONES LTD
Entity Type:Organization
Organization Name:CRUM,STEFANKO AND JONES LTD
Other - Org Name:RUBY CREST EMERGENCY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-251-6933
Mailing Address - Street 1:993 COURT ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-3942
Mailing Address - Country:US
Mailing Address - Phone:775-777-0935
Mailing Address - Fax:775-777-0937
Practice Address - Street 1:2001 ERRECART BLVD
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8333
Practice Address - Country:US
Practice Address - Phone:775-777-0935
Practice Address - Fax:775-777-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100508921Medicaid
NV100508921Medicaid