Individual
JONATHAN WESLEY CREWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1815 CLARKSON RD, CHESTERFIELD, MO 63017-5065
(636) 728-0111
(636) 728-0093
Mailing address
1815 CLARKSON RD, CHESTERFIELD, MO 63017-5065
(636) 728-0111
(636) 728-0093
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6748
NE
207W00000X
Ophthalmology Physician
02004847A
IN
207W00000X
Ophthalmology Physician
Primary
2017024010
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017024010
MISSOURI LICENSE
MO
Enumeration date
06/13/2012
Last updated
07/21/2022
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