Individual
LADDIE MOORE CRISP JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 AIRPORT RD, KINSTON, NC 28501-1603
(252) 527-4146
(252) 527-5697
Mailing address
2000 PERIMETER PARK DR STE 200, MORRISVILLE, NC 27560-8442
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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