Individual
JACK HAROLD CRAWFORD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 934-6007
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28267
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03624075
—
MS
01
—
051116157
BCBS
AL
01
—
051116159
BCBS
AL
01
—
051116160
BCBS
AL
01
—
051116162
BCBS
AL
05
—
128250
—
AL
05
—
128252
—
AL
05
—
128256
—
AL
05
—
128258
—
AL
Enumeration date
06/07/2007
Last updated
07/27/2011
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