Provider Demographics
NPI:1790760015
Name:CRAWFORD, JOHN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAY
Last Name:CRAWFORD
Suffix:
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 1:1422 OLD WEISGARBER RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1293
Mailing Address - Country:US
Mailing Address - Phone:865-558-4400
Mailing Address - Fax:865-558-4471
Practice Address - Street 1:260 FORT SANDERS WEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3355
Practice Address - Country:US
Practice Address - Phone:865-769-4545
Practice Address - Fax:865-769-4501
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25960207XP3100X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00995322OtherRAILROAD MEDICARE
TN01N3OtherUNITED HEALTHCARE
9602776OtherCIGNA
9627057OtherAETNA
TN3711675Medicare PIN
TNP00995322OtherRAILROAD MEDICARE
9627057OtherAETNA
TN30009252Medicare PIN
NCH16133Medicare UPIN
TN30009251Medicare PIN