Provider Demographics
NPI:1083793640
Name:CROW, PAUL CLINTON (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CLINTON
Last Name:CROW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 DOVER RD
Mailing Address - Street 2:GRIFFIN CENTER
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-4155
Mailing Address - Country:US
Mailing Address - Phone:931-906-2055
Mailing Address - Fax:931-906-2172
Practice Address - Street 1:255 DOVER RD
Practice Address - Street 2:GRIFFIN CENTER
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-4155
Practice Address - Country:US
Practice Address - Phone:931-906-2055
Practice Address - Fax:931-906-2172
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5673896OtherCIGNA
TN3723215Medicaid
TN4075961OtherBLUE CROSS BLUE SHIELD
TN3971257Medicare PIN
TNU97921Medicare UPIN