Organization
CAVE RUN ORTHOPEDICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES EDWIN CROUSE MD (OWNER)
(606) 784-7551
Entity
Organization
Contact information
Practice address
1350 FLEMINGSBURG RD, MOREHEAD, KY 40351-1810
(606) 462-8016
(606) 462-8046
Mailing address
1350 FLEMINGSBURG RD, MOREHEAD, KY 40351-1810
(606) 462-8016
(606) 462-8046
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D2186089
CLIA WAIVER
—
05
—
7100670190
—
KY
05
—
7100670440
—
KY
05
—
7100672660
—
KY
Enumeration date
04/17/2020
Last updated
06/22/2022
Update your record
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