Provider Demographics
NPI:1962542035
Name:MCCRELESS, N FRANK II (PC)
Entity type:Individual
Prefix:
First Name:N
Middle Name:FRANK
Last Name:MCCRELESS
Suffix:II
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:
Mailing Address - City:DOUBLE SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:35553-0514
Mailing Address - Country:US
Mailing Address - Phone:205-489-3393
Mailing Address - Fax:205-489-5259
Practice Address - Street 1:25179 HIGHWAY 195
Practice Address - Street 2:
Practice Address - City:DOUBLE SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:35553
Practice Address - Country:US
Practice Address - Phone:205-489-3393
Practice Address - Fax:205-489-5259
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1853111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051040256OtherBLUE CROSS BLUE SHIELD
AL000077806Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ALU70191Medicare UPIN