1154833689 NPI number — MONICA HANDY CRAWFORD, MD, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154833689 NPI number — MONICA HANDY CRAWFORD, MD, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONICA HANDY CRAWFORD, MD, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154833689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8133
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNISTON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36202-8133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-239-5554
Provider Business Mailing Address Fax Number:
256-513-7116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 NOBLE ST STE 1022
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNISTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36201-5698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-239-5554
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2017

Additional Information

Authorized Official

Authorized Official Last Name:
CRAWFORD
Authorized Official First Name:
MONICA
Authorized Official Middle Name:
HANDY
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
256-239-5554

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 117849 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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