Provider Demographics
NPI:1427084060
Name:CREWS, KIRK LEROY (MD)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:LEROY
Last Name:CREWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 66
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:MT
Mailing Address - Zip Code:59872
Mailing Address - Country:US
Mailing Address - Phone:406-822-4803
Mailing Address - Fax:406-822-3848
Practice Address - Street 1:1208 6TH AVE E.
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:MT
Practice Address - Zip Code:59872
Practice Address - Country:US
Practice Address - Phone:406-822-4803
Practice Address - Fax:406-822-3848
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8219207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0081889Medicaid
MTG81394Medicare UPIN
MT000084174Medicare PIN