Provider Demographics
NPI:1215257597
Name:CRENSHAW, BRITTANY FOULKES (MD)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:FOULKES
Last Name:CRENSHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:907 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31643-1315
Mailing Address - Country:US
Mailing Address - Phone:229-263-4531
Mailing Address - Fax:229-263-5787
Practice Address - Street 1:907 N COURT ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:GA
Practice Address - Zip Code:31643-1315
Practice Address - Country:US
Practice Address - Phone:229-263-4531
Practice Address - Fax:229-263-5787
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA69115207R00000X
FLME 114901207R00000X
IN01078331A207R00000X
NY288757207R00000X
PAMD461595207R00000X
MA271382207R00000X
NJ25MA10200500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine