Individual
CAROLYN DIANE CRISPELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6622
(607) 763-5064
Mailing address
3708 JEFFERSON ST, STE A, AUSTIN, TX 78731-6206
(607) 729-8156
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
239067
NY
207R00000X
Internal Medicine Physician
Primary
R7696
TX
208M00000X
Hospitalist Physician
239067
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02886620
—
NY
Enumeration date
04/10/2007
Last updated
08/28/2018
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