Provider Demographics
NPI:1417063017
Name:JAMES G CRAWFORD
Entity Type:Organization
Organization Name:JAMES G CRAWFORD
Other - Org Name:CRAWFORD PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:336-275-5571
Mailing Address - Street 1:107 N MURROW BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2958
Mailing Address - Country:US
Mailing Address - Phone:336-275-5571
Mailing Address - Fax:336-274-2686
Practice Address - Street 1:107 N MURROW BLVD
Practice Address - Street 2:STE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2958
Practice Address - Country:US
Practice Address - Phone:336-275-5571
Practice Address - Fax:336-274-2686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC345213E00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890806JMedicaid
NC890806JMedicaid
4351260001Medicare NSC
NC2433457Medicare PIN