Individual
LAURA M. CRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4138
(859) 258-4796
Mailing address
350 ELAINE DR, SUITE 204, LEXINGTON, KY 40504-2754
(859) 258-4508
(859) 258-6122
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
34875
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34875
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0169
LC MEDICARE GROUP ID
KY
01
—
65923740
LC MEDICAID GROUP ID
KY
05
—
7100077490
—
KY
Enumeration date
04/14/2008
Last updated
07/29/2011
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