Provider Demographics
NPI:1013968742
Name:CROMPTON, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:CROMPTON
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 1:2520 VALLEY DRIVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550
Mailing Address - Country:US
Mailing Address - Phone:304-675-2781
Mailing Address - Fax:304-675-2783
Practice Address - Street 1:1600 MEDICAL CENTER DR STE G500
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3659
Practice Address - Country:US
Practice Address - Phone:304-691-1262
Practice Address - Fax:304-691-1666
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098276207X00000X
WV22602207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001930213OtherMOUNTAIN STATE BCBS
WV3810007771Medicaid
WV5162191OtherUNITED HEALTHCARE
OH0060068Medicaid
WV3810018136Medicaid
WV563182OtherCARELINK
WV001930217OtherBCBS
WV4611047OtherAETNA
OH0060068Medicaid
WVWV2830AMedicare PIN
WV563182OtherCARELINK
CR4201463Medicare PIN
CR4201463Medicare PIN