Basic Information
| Provider Information | |||||||||
| NPI: | 1295733533 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CREWS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 MEMORIAL DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | DANVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245411680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347993232 | ||||||||
| FaxNumber: | 4347925125 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 MEMORIAL DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | DANVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245411680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347993232 | ||||||||
| FaxNumber: | 4347925125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 12/11/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 0618000031 | VA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.