Individual
MR. JEFFREY ELLIOTT CRYDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
179 MASON PHILIP DRIVE, MACON, GA 31216-7366
(706) 319-7470
Mailing address
179 MASON PHILIP DR, MACON, GA 31216-7366
(706) 319-7470
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN166777
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812134122A
—
GA
05
—
812134122B
—
GA
Enumeration date
05/28/2008
Last updated
11/26/2008
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