Provider Demographics
NPI:1073506754
Name:CRIDER, JAMES ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:CRIDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4000
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684-4000
Mailing Address - Country:US
Mailing Address - Phone:423-926-1171
Mailing Address - Fax:423-979-3685
Practice Address - Street 1:JAMES H. QUILLEN VA MEDICAL CENTER
Practice Address - Street 2:CORNER OF LAMONT & VETERANS WAY
Practice Address - City:MT. HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:423-979-3685
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY35809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine