Crecelius, Jeffrey Lawrence

Crecelius, Jeffrey Lawrence is an individual health care provider with primary practice located at 721 American Ave Ste 108 , Waukesha WI 53188-5071. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Crecelius, Jeffrey Lawrence can be contacted via phone (262) 928-8200.

Contact Information

Primary practice address
721 American Ave Ste 108 Waukesha WI 53188-5071
Phone: (262) 928-8200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 01036963A Indiana
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 69263-20 Wisconsin

Profile Details

NPI number 1477521573
LBN Legal business name Crecelius, Jeffrey Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Mar 31st, 2022 - about 3 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 1477521573 NPPES
Indiana Other 10824947 CAQH NUMBER
Indiana Other 000000580227 CAQH NUMBER
Indiana MEDICAID 100087570 CAQH NUMBER

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