| Doctor Name: | DR. JASON WEST CROMAR |
| NPI Number: | 1902008980 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., M.P.H. |
| License Number: | |
| Business Practice Address: | 208 W D L Ingram Blvd 27 Somdg/sgp Cannon Afb, NM - 881035103 |
| Business Phone Number: | 5757847801 |
| Business Fax Number: | 5757846329 |
| Mailing Address: | 208 W D L Ingram Blvd, 27 Somdg/sgp CANNON AFB |
| State: | NM |
| Postal Code: | 881035103 |
| Phone Number: | 5757847801 |
| Fax Number: | |
| NPI Enumeration Date: | 06/01/2007 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |