Organization
DR. JAMES M CROAK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW J. CROAK D.O. (OWNER)
(419) 893-7134
Entity
Organization
Contact information
Practice address
28442 E RIVER RD STE 111, PERRYSBURG, OH 43551-2795
(419) 893-7134
(419) 893-6942
Mailing address
28442 E RIVER RD STE 111, PERRYSBURG, OH 43551-2795
(419) 893-7134
(419) 893-6942
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
34-00-6843-C
OH
207VG0400X
Gynecology Physician
—
OH
208800000X
Urology Physician
—
OH
363LW0102X
Women's Health Nurse Practitioner
07610-NP
OH
363LW0102X
Women's Health Nurse Practitioner
NP-01213
OH
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
COA-16001
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2476815
—
OH
Enumeration date
12/06/2006
Last updated
03/06/2018
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