Healthcare Provider Details

I. General information

NPI: 1336311240
Provider Name (Legal Business Name): CARRIE ANN CRIGGER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 SPARKS AVE SUITE 403
JEFFERSONVILLE IN
47130-3739
US

IV. Provider business mailing address

PO BOX 776351
CHICAGO IL
60677-6351
US

V. Phone/Fax

Practice location:
  • Phone: 812-288-9141
  • Fax: 812-288-1023
Mailing address:
  • Phone: 502-559-9337
  • Fax: 502-272-5339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number02003801A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: