Provider Demographics
NPI:1891895553
Name:CRIGHTON, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:CRIGHTON
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 1:1230 E KINGSLEY ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-7211
Mailing Address - Country:US
Mailing Address - Phone:417-882-2349
Mailing Address - Fax:417-882-1083
Practice Address - Street 1:1230 E KINGSLEY ST
Practice Address - Street 2:SUITE C
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-7211
Practice Address - Country:US
Practice Address - Phone:417-882-2349
Practice Address - Fax:417-882-1083
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO30171208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200896124Medicaid
MO200896124Medicaid
MOA12662Medicare UPIN