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NPI Code Detail

MEDICARE: FRANKLIN CHASE CRUMPTON PA-C

MEDICARE: FRANKLIN CHASE CRUMPTON PA-C
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
1363AS0400XSurgical Physician Assistant3362TN
2363AM0700XMedical Physician Assistant3362TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13362OTHERTNSTATE LICENSE
21136178OTHERMSNCCPA
31136178OTHERTNNCCPA
4PA00505OTHERMSSTATE LICENSE

General Provider Information

NPI Number : 1922523026
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANKLIN CHASE CRUMPTON PA-C
Provider Business Mailing Address
First Line : 1211 S GLOSTER ST
Second Line :
City : TUPELO
State : MS
Zip : 38801-6546
Country : US
Telephone Number : 662-767-4200
Fax Number : 662-767-4201
Provider Business Practice Location Address
First Line : 1211 S GLOSTER ST STE A
Second Line :
City : TUPELO
State : MS
Zip : 38801-6548
Country : US
Telephone Number : 662-767-4200
Fax Number : 662-767-4201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2017
Last Update Date : 03/06/2023

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Directions to “ FRANKLIN CHASE CRUMPTON PA-C” Practice Location

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