Individual
DR. JEFFREY PAUL CRITTENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 SHADOWLINE DR, SUITE 202, BOONE, NC 28607-5089
(828) 262-0600
(828) 262-0807
Mailing address
400 SHADOWLINE DR, SUITE 202, BOONE, NC 28607-5089
(828) 262-0600
(828) 262-0807
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
9601279
NC
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
77
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144300286
NPI- GROUP
NC
01
—
130011654
MEDICARE RR
NC
01
—
2338527
GROUP MEDICARE
NC
01
—
791120X
MEDICAID GROUP
NC
05
—
89015NT
—
NC
Enumeration date
03/16/2006
Last updated
04/19/2012
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