Individual
DR. MAX JAY CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
97 S. PROFESSIONAL WAY, PAYSON, UT 84651
(801) 465-4896
(801) 465-3267
Mailing address
1055 N 500 W, PROVO, UT 84604-3305
(801) 465-4896
(801) 465-3267
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
181049-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181049-1205
STATE LICENSE
UT
Enumeration date
11/29/2006
Last updated
12/22/2011
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