J L Crow Plastic Surgery Services

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4766 Issued in ND

Legal business name

J L CROW PLASTIC SURGERY SERVICES

Practice address

1191 South Columbia Road
Grand Forks, ND 58201-4033

Phone

(701) 335-9717

Fax

(701) 746-1663

NPI assigned

Oct 25, 2012

Last updated

Oct 25, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Judson L Crow, MD

Title

President / Owner / Physician

Phone

(218) 779-9347

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1629321856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 SOUTH COLUMBIA ROAD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014033",
            "telephone_number": "701-335-9717",
            "fax_number": "701-746-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 SOUTH COLUMBIA ROAD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014033",
            "telephone_number": "701-335-9717",
            "fax_number": "701-746-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J L CROW PLASTIC SURGERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "CROW",
        "authorized_official_first_name": "JUDSON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT / OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "218-779-9347",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "27269",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "ND",
            "license": "4766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14106",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ehinor Edmond Isidahome, MD
• Ewaenosa Esohe Isidahome, MD
• Lisa Isler, NP
• Leah Ista, MD
• Amie Beth Iverson
• J&N Operations LLC (Grand Forks Taxi)
• David A Jackson, PHD
• Kacie Jackson
• Ramona Lee Jackson
• Joel Jacob

• Plastic Surgery Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Plastic Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.