Individual
JOHN STUART CRUTCHFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
722 CLINIC DR, TYLER, TX 75701-2001
(903) 531-9901
(903) 531-9739
Mailing address
722 CLINIC DR, TYLER, TX 75701-2001
(903) 531-9901
(903) 531-9739
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
H6140
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019KV
BLUE CROSS BLUE SHIELD
TX
05
—
163049302
—
TX
Enumeration date
11/10/2005
Last updated
06/21/2010
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