Individual
JUSTIN MICHAEL CROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
934 DOUGHERTY RD, AIKEN, SC 29803-6515
(036) 430-0588
(803) 643-1776
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7263
(706) 774-7230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1895
SC
363AS0400X
Surgical Physician Assistant
008321
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1647PA
—
SC
Enumeration date
10/03/2012
Last updated
12/21/2020
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