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Individual

DR. JIM D CROWLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1055 N 500 W, SUITE 211, PROVO, UT 84604-3305
(801) 357-7327
(801) 375-8860
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
10095
NV
208800000X
Urology Physician
Primary
7420231-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002018585
NV
Enumeration date
11/23/2005
Last updated
10/22/2018
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