Crooms, Jeffrey Wyatt

Crooms, Jeffrey Wyatt is an individual health care provider with primary practice located at 1405 Centerville Rd Suite 4400, Tallahassee FL 32308-4655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Crooms, Jeffrey Wyatt can be contacted via phone (850) 877-6212.

Contact Information

Primary practice address
1405 Centerville Rd Suite 4400 Tallahassee FL 32308-4655
Fax: (850) 878-4034
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME0043049 Florida

Profile Details

NPI number 1467554618
LBN Legal business name Crooms, Jeffrey Wyatt
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2006
Last updated Nov 24th, 2014 - about 10 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 1467554618 NPPES
Florida MEDICAID 0402681-00

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