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Individual

JOSEPH D. CRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5586
(740) 446-5749
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5000
(740) 446-5854

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1629
WV
207P00000X
Emergency Medicine Physician
Primary
34-00-5987
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000006632
ANTHEM BCBS
01
000000185504
UNISON MEDICAID
01
001714100
MOUNTAIN STATE BCBS
05
0048004000
WV
01
2035032
MOLINA MEDICAID
OH
05
2035032
OH
01
310917085153
OH MEDICAID CARESOURCE
OH
01
930054111
RR MEDICARE
Enumeration date
05/17/2006
Last updated
03/14/2011
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