Crenshaw, Daryl O

Crenshaw, Daryl O is an individual health care provider with primary practice located at 334 Smith Ave , Thomasville GA 31792-5533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Crenshaw, Daryl O can be contacted via phone (229) 227-1595.

Contact Information

Primary practice address
334 Smith Ave Thomasville GA 31792-5533
Fax: (229) 227-1385
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 56036 Georgia

Profile Details

NPI number 1528123965
LBN Legal business name Crenshaw, Daryl O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Sep 13th, 2018 - about 7 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 1528123965 NPPES
Georgia MEDICAID 720019553H
Georgia MEDICAID 720019553D
Georgia MEDICAID 720019553A
Georgia MEDICAID 720019553I
Georgia MEDICAID 720019553F
Georgia MEDICAID 720019553B
Georgia MEDICAID 720019553C
Georgia MEDICAID 720019553G
Georgia MEDICAID 720019553E

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