Provider Demographics
NPI:1841348919
Name:CRABTREE, J.R. RAY (DC)
Entity type:Individual
Prefix:DR
First Name:J.R.
Middle Name:RAY
Last Name:CRABTREE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 E RACE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4418
Mailing Address - Country:US
Mailing Address - Phone:501-279-2009
Mailing Address - Fax:501-279-3009
Practice Address - Street 1:607 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4418
Practice Address - Country:US
Practice Address - Phone:501-279-2009
Practice Address - Fax:501-279-3009
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5U171Medicare UPIN