Provider Demographics
NPI:1477550283
Name:CREECH, ERIKA HAZARD (MD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:HAZARD
Last Name:CREECH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MERIDIAN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-5900
Mailing Address - Country:US
Mailing Address - Phone:731-256-0526
Mailing Address - Fax:731-256-1720
Practice Address - Street 1:21 MERIDIAN SPRINGS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-5900
Practice Address - Country:US
Practice Address - Phone:731-256-0526
Practice Address - Fax:731-256-1720
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24799207Q00000X
TNMD024799332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33809OtherTLC
TN626001636OtherUSA MANAGED CARE
TNP00223670OtherRAILROAD MEDICARE
TN4099359OtherBLUE CROSS BLUE SHIELD
TN162154OtherBETTER HEALTH
TN0725896OtherCIGNA
TN626001636OtherHEALTH PARTNERS
TN3078636Medicaid
TN626001636OtherUNITED HEALTHCARE
TN626001636OtherHEALTH PARTNERS
TN3078636Medicaid