Organization
STATESBORO ENT SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS M CREWS M.D. (OWNER)
(912) 764-8200
Entity
Organization
Contact information
Practice address
106 PROCTOR ST, STATESBORO, GA 30458-1351
(912) 764-8200
Mailing address
106 PROCTOR ST, STATESBORO, GA 30458-1351
(912) 764-8200
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN123377
GA
367500000X
Certified Registered Nurse Anesthetist
RN139429
GA
367500000X
Certified Registered Nurse Anesthetist
RN177700
GA
367500000X
Certified Registered Nurse Anesthetist
RN179667
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033285838
NPI
GA
01
—
1437151123
NPI
GA
01
—
1629026851
NPI
GA
01
—
1750612057
NPI
GA
Enumeration date
08/14/2014
Last updated
08/14/2014
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