Provider Demographics
NPI:1922523026
Name:CRUMPTON, FRANKLIN CHASE (PA-C)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:CHASE
Last Name:CRUMPTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S GLOSTER ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6546
Mailing Address - Country:US
Mailing Address - Phone:662-767-4200
Mailing Address - Fax:662-767-4201
Practice Address - Street 1:1211 S GLOSTER ST STE A
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6548
Practice Address - Country:US
Practice Address - Phone:662-767-4200
Practice Address - Fax:662-767-4201
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3362363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3362OtherSTATE LICENSE
MS1136178OtherNCCPA
TN1136178OtherNCCPA
MSPA00505OtherSTATE LICENSE