Crouch, Earl Russell

Crouch, Earl Russell is an individual health care provider with primary practice located at 4665 South Blvd , Virginia Beach VA 23452-1055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Crouch, Earl Russell can be contacted via phone (757) 461-0050.

Contact Information

Primary practice address
4665 South Blvd Virginia Beach VA 23452-1055
Fax: (757) 461-4538
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101236715 Virginia

Profile Details

NPI number 1376632075
LBN Legal business name Crouch, Earl Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Oct 17th, 2018 - about 8 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 1376632075 NPPES
Virginia MEDICAID 010079543

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