Provider Demographics
NPI:1104948728
Name:CROUCH, MARGARET W
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:W
Last Name:CROUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3652 OXFORD CT
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-2671
Mailing Address - Country:US
Mailing Address - Phone:859-380-0787
Mailing Address - Fax:859-344-0034
Practice Address - Street 1:3652 OXFORD CT
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-2671
Practice Address - Country:US
Practice Address - Phone:859-380-0787
Practice Address - Fax:859-344-0034
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist