Healthcare Provider Details

I. General information

NPI: 1629079793
Provider Name (Legal Business Name): JAMES M CRUMB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 BAYMOOR WAY
LAKE MARY FL
32746-7023
US

IV. Provider business mailing address

PO BOX 770297
WINTER GARDEN FL
34777-0297
US

V. Phone/Fax

Practice location:
  • Phone: 689-219-3922
  • Fax:
Mailing address:
  • Phone: 251-345-0773
  • Fax: 251-236-7345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number24535
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number24535
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME172910
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: