Provider Demographics
NPI:1629808423
Name:CRAYTON, JESSE JAMES
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:JAMES
Last Name:CRAYTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8247 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:STONEWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26301-8113
Mailing Address - Country:US
Mailing Address - Phone:304-203-2000
Mailing Address - Fax:
Practice Address - Street 1:8247 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:STONEWOOD
Practice Address - State:WV
Practice Address - Zip Code:26301-8113
Practice Address - Country:US
Practice Address - Phone:304-203-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant