Individual
DR. JERRY DEAN CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 NW 11TH ST, SUITE E19, HERMISTON, OR 97838-8605
(541) 289-7171
(541) 289-7172
Mailing address
600 NW 11TH ST, SUITE E19, HERMISTON, OR 97838-8605
(541) 289-7171
(541) 289-7172
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
G87585
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
461055178
TAX ID#
OR
Enumeration date
04/17/2006
Last updated
02/07/2013
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