Provider Demographics
NPI:1932150430
Name:CROUCH, DAVID N (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:CROUCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-584-1363
Practice Address - Street 1:11808 KINGSTON PIKE
Practice Address - Street 2:STE 160
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3803
Practice Address - Country:US
Practice Address - Phone:865-966-3940
Practice Address - Fax:865-966-6914
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-11-16
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Provider Licenses
StateLicense IDTaxonomies
TN42219207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000583Medicaid
G47316Medicare UPIN
TN103I087754Medicare PIN