Individual
DR. CASEY JACK CRONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(645) 606-8068
(864) 560-7329
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
071594
GA
207RI0200X
Infectious Disease Physician
Primary
39100
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391043
—
SC
01
—
SC86643365
MEDICARE PIN
SC
Enumeration date
03/19/2014
Last updated
12/15/2020
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