Provider Demographics
NPI:1295733533
Name:CREWS, JOHN E (OD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:CREWS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 MEMORIAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1680
Mailing Address - Country:US
Mailing Address - Phone:434-799-3232
Mailing Address - Fax:434-792-5125
Practice Address - Street 1:800 MEMORIAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1680
Practice Address - Country:US
Practice Address - Phone:434-799-3232
Practice Address - Fax:434-792-5125
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0618000031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0197070001Medicare NSC
T21751Medicare UPIN