Mccrery, Jerry E
Mccrery, Jerry E is an individual health care provider with primary practice located at 1527 Broadway St , Alexandria MN 56308-2537. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Mccrery, Jerry E can be contacted via phone (320) 762-0399.Contact Information
Primary practice address
1527 Broadway St
Alexandria MN 56308-2537
Phone: (320) 762-0399
Fax: (320) 762-6847
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 022578 | Minnesota |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 22578 | Minnesota |
Profile Details
| NPI number | 1255311866 |
|---|---|
| LBN Legal business name | Mccrery, Jerry E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2006 |
| Last updated | Jul 29th, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255311866 | NPPES |
| Minnesota | Other | A009 | CHAMPUS |
| Minnesota | Other | 0400552 | CHAMPUS |
| Minnesota | MEDICAID | 738285500 | CHAMPUS |
| Minnesota | Other | 121118D277 | CHAMPUS |
| Minnesota | Other | 763172 | CHAMPUS |
| Minnesota | Other | HP24911 | CHAMPUS |
| Minnesota | Other | 1000248 | CHAMPUS |
| Minnesota | Other | 31T05MC | CHAMPUS |
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