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Dr. Jack Lee Crain, MD
Specialist in Charlotte, North Carolina
NPI 1073583555

Jack Lee Crain is a Specialist based in Charlotte, NC. Jack Lee Crain practices in Charlotte, NC and has the professional credentials of MD. The NPI Number for Jack Lee Crain is 1073583555 and holds a License No. (North Carolina).

The current practice location address for Jack Lee Crain is 1524 E Morehead St, Charlotte, NC and can be reached out via phone at 704-343-4452 and via fax at 704-343-3428.

Location: 1524 E Morehead St, Charlotte, NC, 28207-1606
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073583555
Provider Name
Jack Lee Crain
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1524 E Morehead St, Charlotte, NC, 28207-1606
Phone Number
704-343-4452
Fax Number
704-343-3428
Provider Enumeration Date
01/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200001202683 01 NC PHYS PRIVILEGE LICENSE
28480 01 NC MEDICAL BOARD LICENSE
institution
Provider Business Practice Location Address Details
Address
1524 E Morehead St
City
Charlotte
State
North Carolina
Zip
28207-1606
Phone Number
704-343-4452
Fax Number
704-343-3428
person
Provider Business Mailing Address Details
Address
1524 E Morehead St
City
Charlotte
State
North Carolina
Zip
28207-1606
Phone Number
704-343-4452
Fax Number
704-343-3428
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
(North Carolina)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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