Organization
COMMUNITY SURGICAL CENTER DR. DAVID CRUMP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN RUTLEDGE (ADMINISTRATOR)
(601) 947-1330
Entity
Organization
Contact information
Practice address
57 RATLIFF ST, LUCEDALE, MS 39452-5731
(601) 766-0308
(601) 766-0309
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 766-0308
(601) 766-0309
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00539212
—
MS
01
—
C03241
MEDICARE CAHABA
MS
01
—
DD0421
PALMETTO MEDICARE RAILROA
MS
Enumeration date
10/16/2006
Last updated
08/08/2023
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