Provider Demographics
NPI:1053505479
Name:COMPTON, CRYSTAL KAY (DO)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:KAY
Last Name:COMPTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CRYSTAL
Other - Middle Name:KAY
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 2288
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2288
Mailing Address - Country:US
Mailing Address - Phone:606-432-2172
Mailing Address - Fax:
Practice Address - Street 1:50 WEDDINGTON BRANCH RD
Practice Address - Street 2:SUITE B
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3296
Practice Address - Country:US
Practice Address - Phone:606-432-2172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03120207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100080360Medicaid
KYK186000Medicare PIN