Individual
DR. JEREMY PATRICK CRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 S JACKSON ST, C1R06, LOUISVILLE, KY 40202-1675
(502) 852-3368
(502) 852-1771
Mailing address
530 S JACKSON ST, C1R06, LOUISVILLE, KY 40202-1675
(502) 852-3368
(502) 852-1771
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
BP1-0022237
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
7359483-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2790078891
MYUTMB 2790078891-COMMERCIAL NUMBER
—
Enumeration date
06/15/2007
Last updated
03/28/2013
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