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Individual

RACHEL ANN CRUDGINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 535-3611
(770) 535-7092
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 533-4786

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
060718
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01184316
AMERIGROUP
GA
05
178218352A
GA
05
178218352B
GA
05
178218352C
GA
05
178218352D
GA
05
178218352E
GA
01
453382
WELLCARE
GA
01
453415
WELLCARE
GA
01
453425
WELLCARE
GA
01
453429
WELLCARE
GA
01
52245265
BCBS
GA
01
530894
WELLCARE
GA
01
582117020
TRICARE
GA
01
582117020018
TRICARE
GA
01
582117020024
TRICARE
GA
01
582117020030
TRICARE
GA
01
8974812
CIGNA
GA
01
9806158
AETNA
GA
Enumeration date
04/03/2007
Last updated
08/17/2023
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