Organization
DIABETES CENTER OF JESUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL CRAWFORD FNP (OWNER)
(912) 339-2342
Entity
Organization
Contact information
Practice address
124 MEMORIAL DR, JESUP, GA 31545-0101
(912) 750-0011
(833) 740-4346
Mailing address
24 GLENDALE AVE STE E, BAXLEY, GA 31513-0245
(123) 102-3839
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2024
Last updated
01/22/2024
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