Individual
ROSA CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1101 OCILLA RD, DOUGLAS, GA 31533-2207
(912) 384-1900
Mailing address
1101 OCILLA RD, P.O BOX 1287, DOUGLAS, GA 31533-2207
(912) 384-1900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006818
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003138098C
—
GA
05
—
013953700
—
FL
Enumeration date
06/10/2013
Last updated
05/15/2015
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