Provider Demographics
NPI:1225118441
Name:CRUMP, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:CRUMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MEDICAL CENTER BLVD
Mailing Address - Street 2:STEG25
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-2684
Mailing Address - Country:US
Mailing Address - Phone:931-438-7344
Mailing Address - Fax:
Practice Address - Street 1:108 MEDICAL CENTER BLVD STE G25
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-2741
Practice Address - Country:US
Practice Address - Phone:931-438-7344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13246208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00205316OtherPALMETTO MEDICARE RAILROA
MS00121751Medicaid
MSC03241OtherMEDICARE CAHABA
MS00121751Medicaid
MSC03241OtherMEDICARE CAHABA