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Individual
LADDIE MOORE CRISP JR.
Active
Individual
LADDIE MOORE CRISP JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32676
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-28746
UNITED HEALTHCARE
NC
01
—
25754
BCBS/NC
NC
01
—
41528
MEDCOST
NC
01
—
5868476
AETNA INSURANCE
NC
05
—
8925754
—
NC
Enumeration date
09/23/2006
Last updated
05/06/2021
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