Provider Demographics
NPI:1366409609
Name:JOHN C. CRAWFORD, II
Entity type:Organization
Organization Name:JOHN C. CRAWFORD, II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ASSOCIATE PROVIDERS
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CICERO
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:II
Authorized Official - Credentials:PA-C
Authorized Official - Phone:404-616-6867
Mailing Address - Street 1:3941 JOHN HOPKINS CT
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-5709
Mailing Address - Country:US
Mailing Address - Phone:770-808-6054
Mailing Address - Fax:
Practice Address - Street 1:80 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-6867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001539282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen