Individual
CHARLES EDWIN CROUSE III
Active
Individual
CHARLES EDWIN CROUSE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
42077
KY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
42077
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42077
STATE MEDICAL LICENSE
KY
05
—
7100052230
—
KY
Enumeration date
04/22/2008
Last updated
08/02/2022
Update your record
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