DR. WEYMOTH CROWELL (NPI# 1699718700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699718700 |
Entity Type | Individual |
Full Name | DR. WEYMOTH CROWELL |
Credential | M.D. |
Practice Address |
3502 W Northside Dr Jackson MS 39213-4454 |
Practice Telephone | 6013625321 |
Practice Fax Number | 6013642600 |
Mailing Telephone | 6013625321 |
Mailing Fax Number | 6013642600 |
Enumeration Date | 2006-06-14 |
Last Update Date | 2011-08-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
10659 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 00116236 | 05 |
Street Address |
3502 W NORTHSIDE DR |
City | JACKSON |
State | MS |
Zip Code | 39213-4454 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952386559 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2005-12-07 |
1689217812 | Ebony Martin | Case Manager/Care Coordinator | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-10-21 |
1275189938 | April Terrain Perry | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213 | 2019-08-16 |
1013473891 | Ericia Latrice Cannon | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-02-16 |
1578037172 | Jennifer Henley | Internal Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-01-16 |
1003388968 | Tiffani Ricchele Mcknight | Social Worker | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-12-17 |
1356810360 | Thrishanna Clark | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-11-19 |
1376034660 | Sirna Musa | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-05-23 |
1033649058 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2017-06-13 |
1013451780 | Katrice Pacley Andrews | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2016-12-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
Find all providers in zip 39213 |
Taxonomy Code | 207QA0505X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Adult Medicine |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821032392 | Rachel Antonia Jones | Family Medicine | 866 Medical Plz, Jackson, MS 39204-4948 | 2006-06-15 |
1124072723 | Lynda Catherine Hammond | Family Medicine | 517 Wildwood Ave, Suite B, Jackson, MI 49201-1044 | 2006-05-19 |
1023078128 | Robert D. Langer | Family Medicine | 555 E. Broadway, Suite 108, Jackson, WY 83001 | 2006-03-24 |
1922006279 | Virgil Isaac Aultman | Family Medicine | 2747 Old Canton Rd, Jackson, MS 39216-4308 | 2005-07-11 |
1356856561 | Cassandra Amos Walters | Family Medicine | 1850 Chadwick Dr, Jackson, MS 39204-3404 | 2017-12-11 |
1700076940 | Aqfa Sultana | Family Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2007-07-25 |
1679773113 | Rajvinder Singh Hanspal | Family Medicine | 1815 Hospital Dr, Jackson, MS 39204-3425 | 2007-07-23 |
1942341714 | Billy Ray Register | Family Medicine | 5002 Hwy 10, Jackson, LA 70748-0438 | 2007-02-12 |
1629179171 | Larry D Farr | Family Medicine | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2006-09-26 |
1770519142 | Debra Rice | Family Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-06-25 |
Find all providers in JACKSON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.