Provider Demographics
NPI:1194008383
Name:CROOK, JAMIE HARRISON (AUD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:HARRISON
Last Name:CROOK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ANDREWS AVENUE
Mailing Address - Street 2:
Mailing Address - City:FORT RUCKER
Mailing Address - State:AL
Mailing Address - Zip Code:36362-5333
Mailing Address - Country:US
Mailing Address - Phone:334-255-7192
Mailing Address - Fax:
Practice Address - Street 1:301 ANDREWS AVENUE, EYE AND EAR CLINIC (EENT)
Practice Address - Street 2:LYSTER ARMY HEALTH CLINIC
Practice Address - City:FT. RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36302
Practice Address - Country:US
Practice Address - Phone:334-255-7185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1686231H00000X
GAAUD003979231H00000X
AL1084A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist