Individual
DR. JONATHAN GENTRY CRISP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
340 BAGLEY CIR, MARION, VA 24354-3126
(276) 783-1226
(276) 783-1425
Mailing address
340 BAGLEY CIR, MARION, VA 24354-3126
(276) 783-1226
(276) 783-1425
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101239503
VA
2084P0800X
Psychiatry Physician
9700221
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89024Y
—
VA
Enumeration date
01/24/2006
Last updated
08/10/2008
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