Provider Demographics
NPI:1588687289
Name:LECRAW, FLORENCE R (MD)
Entity type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:R
Last Name:LECRAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:222 12TH ST NE
Mailing Address - Street 2:UNIT 2007
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4001
Mailing Address - Country:US
Mailing Address - Phone:404-234-8244
Mailing Address - Fax:
Practice Address - Street 1:1 BALTIMORE PL NW
Practice Address - Street 2:SUITE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2116
Practice Address - Country:US
Practice Address - Phone:404-885-9675
Practice Address - Fax:404-759-2212
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033222207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000436499NMedicaid
GA20-02624OtherUNITED HEALTHCARE
GA52576387-009OtherBLUE CROSS BLUE SHIELD
GAP00362500OtherRAIL ROAD MEDICARE
GA156961100OtherU.S. DEPT. OF LABOR
GAN359526OtherWELLCARE
GA000436499JMedicaid
GA000436499MMedicaid
GA52576387OtherBCBS OF GA
GA9975585OtherUNIVERSAL HEALTHCARE
GA52576387OtherBCBS OF GA
GA156961100OtherU.S. DEPT. OF LABOR
GAP00362500OtherRAIL ROAD MEDICARE
GA05BDKFLMedicare ID - Type Unspecified
GA000436499JMedicaid