Individual
PAUL LUTHER CRISPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-7537
(859) 323-1944
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-7537
(859) 323-1944
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
42809
KY
208800000X
Urology Physician
49958
MN
208800000X
Urology Physician
Primary
ME115276
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008616900
—
FL
05
—
262123000
—
MN
01
—
P00632037
RAILROAD MEDICARE
MN
Enumeration date
08/01/2007
Last updated
08/19/2013
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