Individual
MARSHALL J CROWTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 REBEL DRIVE, UNIVERSITY, MS 38677
(662) 915-7274
Mailing address
PO BOX 1848, 400 REBEL DRIVE, UNIVERSITY, MS 38677-1848
(662) 915-7274
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
27417
AL
208000000X
Pediatrics Physician
24443
SC
2080S0010X
Pediatric Sports Medicine Physician
Primary
23389
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051593910
BCBS
AL
05
—
104966
—
AL
05
—
114548
—
AL
05
—
125307
—
AL
01
—
51100240
BCBS
AL
01
—
51113111
BCBS
AL
01
—
P00799667
RAILROAD MEDICARE
AL
Enumeration date
07/18/2006
Last updated
12/15/2014
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