Provider Demographics
NPI:1215202148
Name:CRUMLIN, LINDSEY EUGENE JR (MD,MPH,FACS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:EUGENE
Last Name:CRUMLIN
Suffix:JR
Gender:M
Credentials:MD,MPH,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-0369
Mailing Address - Country:US
Mailing Address - Phone:864-426-4578
Mailing Address - Fax:
Practice Address - Street 1:1709 MOBILE AVE
Practice Address - Street 2:SC VOC REHAB DISABILITY DETERMINATION SERVICES
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170-2140
Practice Address - Country:US
Practice Address - Phone:803-896-6789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28781208600000X
SC24920208600000X
FLME60501208600000X
LAMD.017477208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B61566Medicare UPIN