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Individual

DR. JOHN RAYMOND CRUMP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
610 HARGROVE RD E, TUSCALOOSA, AL 35401-3753
(205) 759-1000
(205) 752-2570
Mailing address
610 HARGROVE RD E, TUSCALOOSA, AL 35401-3753
(205) 759-1000
(205) 752-2570

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4626
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529912650
AL
01
92560
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/30/2006
Last updated
08/17/2010
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