Individual
JEFFREY CRISPELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884
Mailing address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
27596020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25601
SECURITY HEALTH PLAN
WI
01
—
31476000
MANAGED HEALTH CARE
WI
05
—
31476000
—
WI
01
—
CRISPELL
WPS
WI
Enumeration date
07/17/2006
Last updated
07/09/2007
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