Provider Demographics
NPI:1659325785
Name:CRABTREE, HERBERT MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:MARK
Last Name:CRABTREE
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:PO BOX 9434
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-9434
Mailing Address - Country:US
Mailing Address - Phone:417-885-3888
Mailing Address - Fax:417-881-7638
Practice Address - Street 1:3801 S NATIONAL AVE
Practice Address - Street 2:WEST TOWER, SUITE 700
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5210
Practice Address - Country:US
Practice Address - Phone:417-885-3888
Practice Address - Fax:417-881-7638
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6588207T00000X
MOR3K18207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2083264004OtherCIGNA HEALTHCARE
MO202835104Medicaid
AR5M326OtherARKANSAS BC/BS
MO02100025000OtherQUAL CHOICE
WA0215053OtherDEPARTMENT OF LABOR WA
MO18942OtherCOX HEALTH PLANS
AR111023001Medicaid
MO4188130001OtherCIGNA MEDICARE
AR5M326OtherARKANSAS FIRST SOURCE
MOC68084OtherUSPS (W/C)
MO0640002OtherUNITED HEALTHCARE
MO8458OtherBLUE CROSS/CHOICE
MO188829OtherHEALTHLINK
AR5M326OtherHEALTH ADVANTAGE
MO1294OtherCOX HEALTH PLANS UPI
MOC68084Medicare UPIN
MO02100025000OtherQUAL CHOICE
MO188829OtherHEALTHLINK
MO2083264004OtherCIGNA HEALTHCARE
MO202835104Medicaid
MO001013401Medicare NSC
AR5M326Medicare PIN
MOMA3058008Medicare PIN