Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD167580 | OR |
NPI | 1003106071 |
---|---|
Provider Name | Dr. Jeffrey David Crawford |
First Address | Salem, OR 97309-5014 |
Second Address | Salem, OR 97301-3934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 10/09/2019 |