Provider Demographics
NPI:1497734784
Name:CRAWLEY, JENNIFER H (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:H
Last Name:CRAWLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 W 110TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1545
Mailing Address - Country:US
Mailing Address - Phone:913-319-8400
Mailing Address - Fax:913-696-0040
Practice Address - Street 1:6650 W 110TH ST STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-491-9299
Practice Address - Fax:913-491-3089
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9E962085R0202X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSCI2562OtherRAILROAD MEDICARE- GROUP
MOCI3618OtherRAILROAD MEDICARE- GROUP
MO3230471AOtherRAILROAD MEDICARE- INDIV
KS3230471BOtherRAILROAD MEDICARE- INDIV
MOCI3618OtherRAILROAD MEDICARE- GROUP
EO9328Medicare UPIN
KS3230471BOtherRAILROAD MEDICARE- INDIV