Individual
DR. JOHN A CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 SAINT MARYS MEDICAL PLZ, SUITE 203, JEFFERSON CITY, MO 65101-1604
(573) 761-7243
(573) 761-7196
Mailing address
200 SAINT MARYS MEDICAL PLZ, SUITE 203, JEFFERSON CITY, MO 65101-1604
(573) 761-7243
(573) 761-7196
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
34746
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200582252
—
MS
Enumeration date
06/30/2006
Last updated
09/28/2012
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