Provider Demographics
NPI:1417218769
Name:CROFTS, JASON BLAIR (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:BLAIR
Last Name:CROFTS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2314 SASSAFRAS ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2722
Mailing Address - Country:US
Mailing Address - Phone:814-452-5105
Mailing Address - Fax:814-452-5097
Practice Address - Street 1:2314 SASSAFRAS ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2722
Practice Address - Country:US
Practice Address - Phone:814-452-5105
Practice Address - Fax:814-452-5097
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOT014460207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine