Crouch, John A

Crouch, John A is an individual health care provider with primary practice located at 200 Saint Marys Medical Plz Suite 203, Jefferson City MO 65101-1604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Crouch, John A can be contacted via phone (573) 761-7243.

Contact Information

Primary practice address
200 Saint Marys Medical Plz Suite 203 Jefferson City MO 65101-1604
Phone: (573) 761-7243
Fax: (573) 761-7196
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 34746 Missouri

Profile Details

NPI number 1003845405
LBN Legal business name Crouch, John A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Sep 28th, 2012 - about 13 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 1003845405 NPPES
Mississippi MEDICAID 200582252

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