Individual
EARL DOUGLAS CREW JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
15196 US HIGHWAY 19 S, THOMASVILLE, GA 31757-4820
(229) 228-4770
(229) 225-9060
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(866) 795-4020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000901
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00207303A3
MCAID
GA
05
—
00207303B3
—
GA
01
—
100013
AVESIS
GA
Enumeration date
01/02/2007
Last updated
03/17/2018
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