Provider Demographics
NPI:1568537173
Name:WILLIAM H. CRIGLER, PA
Entity Type:Organization
Organization Name:WILLIAM H. CRIGLER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:CRIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-748-8608
Mailing Address - Street 1:1415 BLANDING ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2922
Mailing Address - Country:US
Mailing Address - Phone:803-748-8608
Mailing Address - Fax:803-733-1401
Practice Address - Street 1:1415 BLANDING ST
Practice Address - Street 2:SUITE 3
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2922
Practice Address - Country:US
Practice Address - Phone:803-748-8608
Practice Address - Fax:803-733-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7662174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7662OtherSC MEDICAL LICENSE #
SCGP4000Medicaid
SCGP4000Medicaid