Individual
CHESTER L CRUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 HIGH ST, SUITE 2D, HOPKINSVILLE, KY 42240-6300
(270) 885-6101
(270) 885-3563
Mailing address
1717 HIGH ST, SUITE 2D, HOPKINSVILLE, KY 42240-6300
(270) 885-6101
(270) 885-3563
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25188
KY
207Q00000X
Family Medicine Physician
35052673C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000065370
ANTHEM BCBS
KY
01
—
080145712
RAILROAD MEDICARE
—
01
—
610755200
DOL
—
05
—
64251887
—
KY
Enumeration date
02/22/2006
Last updated
08/27/2020
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