Individual
DR. CHARLES RAY CRISPEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2604 HIGH RANGE DR, LAS VEGAS, NV 89134-7564
(702) 522-9203
Mailing address
2604 HIGH RANGE DRIVE, LAS VEGAS, NV 89134
(702) 522-9203
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
DO14538
OR
208000000X
Pediatrics Physician
Primary
DO1575
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299499
—
OR
Enumeration date
12/05/2005
Last updated
04/17/2014
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