Basic Information
| Provider Information | |||||||||
| NPI: | 1497757868 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRAWFORD | ||||||||
| FirstName: | J | ||||||||
| MiddleName: | ERIC | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 188 | ||||||||
| Address2: | |||||||||
| City: | CHILLICOTHE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456010188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407734366 | ||||||||
| FaxNumber: | 7407757855 | ||||||||
| Practice Location | |||||||||
| Address1: | 1049 WESTERN AVE | ||||||||
| Address2: | |||||||||
| City: | CHILLICOTHE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456011104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407734366 | ||||||||
| FaxNumber: | 7407757855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 08/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35064944C | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 311155352 | 01 | OH | PPO NEXT | OTHER | 0101911 | 01 | OH | UNITED HEALTHCARE | OTHER | 0929393 | 05 | OH | MEDICAID | 4545818 | 01 | OH | AETNA | OTHER | 311155352 | 01 | CENTRAL BENEFITS | OTHER | 311155352 | 01 | OH | EMERALD HEALTH | OTHER | 000000118707 | 01 | OH | ANTHEM | OTHER | 311155352001 | 01 | TRICARE | OTHER | 311155352 | 01 | OH | EV BENEFITS | OTHER | 311155352 | 01 | NATIONWIDE | OTHER | 311155352 | 01 | CIGNA | OTHER | 311155352 | 01 | OHIO HEALTH CHOICE | OTHER | 311155352 | 01 | GREAT WEST | OTHER |