Individual
MR. PAUL MATTHEW CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4305 NEW SHEPHERDSVILLE RD, BARDSTOWN, KY 40004
(502) 350-5032
(502) 350-5022
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 274000
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
3007686
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300011007A-KOHMG
—
IN
05
—
7100232210-KOHMG
—
KY
01
—
K074154-KOHMG
KY MEDICARE
KY
01
—
P01977534-KOHMG
RR MEDICARE
KY
Enumeration date
11/24/2008
Last updated
08/09/2019
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