Provider Demographics
NPI:1205095973
Name:CRUM, JAMES BRANDON (DO)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BRANDON
Last Name:CRUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:50 WEDDINGTON BRANCH RD STE C
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-3296
Mailing Address - Country:US
Mailing Address - Phone:606-437-2400
Mailing Address - Fax:606-437-2401
Practice Address - Street 1:50 WEDDINGTON BRANCH RD STE C
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3296
Practice Address - Country:US
Practice Address - Phone:606-437-2400
Practice Address - Fax:606-437-2401
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY031362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65941494Medicaid
WV7200028000OtherWV MEDICAID
KYDC0133OtherRR MEDICARE
KYDC0133OtherRR MEDICARE