Organization
CREWS-PETERS ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE C PETERS CRNA (CRNA)
(870) 934-8010
Entity
Organization
Contact information
Practice address
623 E MATTHEWS AVE, SUITE C, JONESBORO, AR 72401-3145
(870) 934-8010
Mailing address
2612 HIDDEN HILL CIR, JONESBORO, AR 72404-6997
(870) 935-7106
(870) 934-8020
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R33596
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5F604
BLUE CROSS BLUE SHIELD
AR
01
—
5F604
MEDICARE PTAN
—
01
—
DF7011
RAILROAD MEDICARE
—
Enumeration date
07/19/2006
Last updated
03/27/2008
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