Individual
DALLAS PAYNE CRICKENBERGER
Active
Individual
DALLAS PAYNE CRICKENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101-017904
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0097064000
MEDICAID OF WEST VIRGINIA
VA
01
—
1417921362
VIRGINIA HEALTH NETWORK
VA
05
—
1417921362
—
VA
01
—
371194700
BLACK LUNG
VA
01
—
540506332004
TRICARE/CHAMPUS
VA
01
—
P200030655
RAILROAD MEDICARE
VA
Enumeration date
02/16/2006
Last updated
03/10/2014
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