Provider Demographics
NPI:1447691696
Name:CRANE, JAMES E JR
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:CRANE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 BOYTE DR SE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-8455
Mailing Address - Country:US
Mailing Address - Phone:601-695-0210
Mailing Address - Fax:
Practice Address - Street 1:839 BOYTE DR SE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-8455
Practice Address - Country:US
Practice Address - Phone:601-695-0210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-8483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist