Organization
CROWN PATHOLOGY P A
Active
Organization
CROWN PATHOLOGY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TEWKSBURY (OWNER)
(207) 768-4013
Entity
Organization
Contact information
Practice address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4209
(207) 768-4013
Mailing address
27 STATE PARK RD, PRESQUE ISLE, ME 04769-5247
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
012546
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962423814
—
ME
Enumeration date
10/30/2014
Last updated
10/30/2014
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