Individual
DR. LUZ JOVITA CRYSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2202 JORDAN ROAD SW, SUITE 500, FORT PAYNE, AL 35968-3688
(256) 844-2825
(256) 844-2834
Mailing address
2202 JORDAN ROAD SW, SUITE 500, FORT PAYNE, AL 35968-3688
(256) 844-2825
(256) 844-2834
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00018535
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051557585
—
AL
05
—
051558061
—
AL
01
—
510-03714
BCBS
AL
01
—
510-03925
BCBS
AL
05
—
541385610
—
AL
Enumeration date
06/09/2006
Last updated
10/15/2012
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