Provider Demographics
NPI:1447513593
Name:CRAWFORD, JASON NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:NICHOLAS
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3990 NC HIGHWAY 105 S STE 1
Mailing Address - Street 2:
Mailing Address - City:SUGAR MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28604-9887
Mailing Address - Country:US
Mailing Address - Phone:828-898-4585
Mailing Address - Fax:828-373-3298
Practice Address - Street 1:3990 NC HIGHWAY 105 S STE 1
Practice Address - Street 2:
Practice Address - City:SUGAR MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28604-9887
Practice Address - Country:US
Practice Address - Phone:828-898-4585
Practice Address - Fax:828-373-3298
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC201501553207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA207QOOOOXOtherFAMILY MEDICINE