MEDICARE: DR. LINDSEY EUGENE CRUMLIN JR. M.D.,M.P.H.,F.A.C.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	28781	AZ
2	208600000X	Surgery Physician	24920	SC
3	208600000X	Surgery Physician	ME60501	FL
4	208600000X	Surgery Physician	MD.017477	LA

General Provider Information

NPI Number	:	1215202148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDSEY EUGENE CRUMLIN JR. M.D.,M.P.H.,F.A.C.S.

Provider Business Mailing Address
First Line	:	PO BOX 369
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29071-0369
Country	:	US
Telephone Number	:	864-426-4578
Fax Number	:

Provider Business Practice Location Address
First Line	:	1709 MOBILE AVE
Second Line	:	SC VOC REHAB DISABILITY DETERMINATION SERVICES
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29170-2140
Country	:	US
Telephone Number	:	803-896-6789
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2012
Last Update Date	:	03/09/2012

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