Provider Demographics
NPI:1912224866
Name:CROWNER, JASON RYAN (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:RYAN
Last Name:CROWNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:VASCULAR SURGERY CB7212
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-3391
Mailing Address - Fax:919-966-2898
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:VASCULAR SURGERY CB7212
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-3391
Practice Address - Fax:919-966-2898
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC164594390200000X
NC2015008872086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program