Provider Demographics
NPI:1336311240
Name:CRIGGER, CARRIE ANN (DO)
Entity Type:Individual
Prefix:MISS
First Name:CARRIE
Middle Name:ANN
Last Name:CRIGGER
Suffix:
Gender:F
Credentials:DO
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-559-9337
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:207 SPARKS AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3739
Practice Address - Country:US
Practice Address - Phone:812-288-9141
Practice Address - Fax:812-288-1023
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003801A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ4465059OtherIN MEDICARE
KY7100131320Medicaid
IN201016580Medicaid