Provider Demographics
NPI:1881633188
Name:CRAWFORD, JAMES GROVER (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GROVER
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 E MARKET ST
Mailing Address - Street 2:STE 106
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-3265
Mailing Address - Country:US
Mailing Address - Phone:336-275-5571
Mailing Address - Fax:336-274-2686
Practice Address - Street 1:709 E MARKET ST
Practice Address - Street 2:STE 106
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-3265
Practice Address - Country:US
Practice Address - Phone:336-275-5571
Practice Address - Fax:336-274-2686
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC345213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890806JMedicaid
NC0806JOtherBCBS PROVIDER NUMBER
NC4351260001Medicare NSC
NC2433457Medicare PIN
T37847Medicare UPIN