Individual
DR. TYLER ALLEN CRISP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1444 PETERMAN DR, ALEXANDRIA, LA 71301-3432
(318) 442-5399
Mailing address
PO BOX 5887, ALEXANDRIA, LA 71307-5887
(318) 442-5399
(318) 442-1586
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
301690
LA
207L00000X
Anesthesiology Physician
R2898
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2424050
—
LA
Enumeration date
04/30/2012
Last updated
09/15/2016
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