Healthcare Provider Details

I. General information

NPI: 1528974862
Provider Name (Legal Business Name): ALEXANDER MILES CRIPPIN HIS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S CRESCENT DR STE 100
MASON CITY IA
50401-2910
US

IV. Provider business mailing address

250 S CRESCENT DR STE 100
MASON CITY IA
50401-2910
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-5180
  • Fax: 641-494-5185
Mailing address:
  • Phone: 641-494-5180
  • Fax: 641-494-5185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number113457
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: