Provider Demographics
NPI:1437116456
Name:CRAWFORD, GEORGE I JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:I
Last Name:CRAWFORD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 WOODSTOCK AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4708
Mailing Address - Country:US
Mailing Address - Phone:256-240-7272
Mailing Address - Fax:256-240-7242
Practice Address - Street 1:1105 WOODSTOCK AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4708
Practice Address - Country:US
Practice Address - Phone:256-240-7272
Practice Address - Fax:256-240-7242
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026618174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51002057OtherBLUE CROSS BLUE SHIELD
AL009932497Medicaid
AL009932497Medicaid
AL51002057OtherBLUE CROSS BLUE SHIELD