Individual
DR. LARRY K CRUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4510 OFFICE PARK DR, JACKSON, MS 39206-6016
(601) 981-3001
(601) 981-8999
Mailing address
4510 OFFICE PARK DR, JACKSON, MS 39206-6016
(601) 981-3001
(601) 981-8999
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
80152
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120141
—
MS
Enumeration date
03/30/2007
Last updated
06/30/2008
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