Crothers, Jacob Emerson

Crothers, Jacob Emerson is an individual health care provider with primary practice located at 222 Saint John St Ste 322 , Portland ME 04102-3059. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Crothers, Jacob Emerson can be contacted via phone (207) 560-3422.

Contact Information

Primary practice address
222 Saint John St Ste 322 Portland ME 04102-3059
Phone: (207) 560-3422
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 052724 Connecticut
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 052724 Connecticut

Profile Details

NPI number 1336433085
LBN Legal business name Crothers, Jacob Emerson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2011
Last updated Jan 26th, 2022 - about 2 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 1336433085 NPPES
Connecticut Other D400163444 MEDICARE FOR CROTHERS
Connecticut Other 008052299 MEDICARE FOR CROTHERS

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