Provider Demographics
NPI:1497757454
Name:CROWL, LORI ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:CROWL
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 1:9471 MARKET ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:44452-8702
Mailing Address - Country:US
Mailing Address - Phone:330-729-2388
Mailing Address - Fax:330-629-6468
Practice Address - Street 1:107 ROYAL BIRKDALE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408
Practice Address - Country:US
Practice Address - Phone:330-482-9350
Practice Address - Fax:330-482-2336
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35072734207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2088584Medicaid
OH2088584Medicaid
OHG78338Medicare UPIN