Crawford, Timothy Wayne

Crawford, Timothy Wayne is an sole proprietor health care provider with primary practice located at 300 Northgate Park Dr , Winston Salem NC 27106-3482. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, which is considered as his primary health care specialty. Crawford, Timothy Wayne can be contacted via phone (336) 499-3622.

Contact Information

Primary practice address
300 Northgate Park Dr Winston Salem NC 27106-3482
Phone: (336) 499-3622
Fax: (336) 499-3624
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X 1576 North Carolina

Profile Details

NPI number 1073565925
LBN Legal business name Crawford, Timothy Wayne
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073565925 NPPES
North Carolina MEDICAID 6000609

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