Jeffrey Crout, MD | |
2500 N State St, Jackson, MS 39216-4500 | |
(601) 984-5200 | |
Not Available |
Full Name | Jeffrey Crout |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2500 N State St, Jackson, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912007949 | NPI | - | NPPES |
00113871 | Medicaid | MS | |
1110086 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 12831 (Mississippi) | Primary |
Entity Name | State Of Mississippi - University Of Mississippi Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154317527 PECOS PAC ID: 1850293036 Enrollment ID: O20090414000575 |
Mailing Address | Practice Location Address |
---|---|
Jeffrey Crout, MD 2500 N State St, Jackson, MS 39216-4500 Ph: (601) 984-5200 | Jeffrey Crout, MD 2500 N State St, Jackson, MS 39216-4500 Ph: (601) 984-5200 |
Lauren K Tucker, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5260 Fax: 601-984-2652 | |
Kavipriya Komeswaran, Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-815-2005 Fax: 601-815-0434 | |
Emily S Weber, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-4520 Fax: 601-984-5982 | |
Mr. Marcelo Eduardo Rains, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 North State Street, Ummc Neonatology, Jackson, MS 39216 Phone: 601-984-1000 | |
Logan Sears Havard, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-1000 | |
Dr. Eva Mae Henderson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 350 W Woodrow Wilson Ave, Jackson, MS 39213 Phone: 601-709-5150 Fax: 601-709-5151 | |
Sitesh Ranen Roy, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5249 |