Individual
JACK BYRON CRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
387 TOWN MOUNTAIN RD, STE 202, PIKEVILLE, KY 41501-1640
(606) 437-1008
(606) 437-5040
Mailing address
387 TOWN MOUNTAIN RD, STE 202, PIKEVILLE, KY 41501-1640
(606) 437-1008
(606) 437-5040
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35982
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1812140000
—
WV
05
—
64031610
—
KY
Enumeration date
09/20/2005
Last updated
06/12/2013
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