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General NPI Number Information
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NPI Number | 1477528339
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Entity Type | Individual
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Provider Name | CHESTER L CRUMP MD
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 1717 HIGH ST SUITE 2D
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-6300
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Country | US
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Telephone | 270-885-6101
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Fax | 270-885-3563
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Provider Business Mailing Address
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Address Line | 1717 HIGH ST SUITE 2D
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-6300
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Country | US
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Telephone | 270-885-6101
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Fax | 270-885-3563
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35052673C
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25188
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License Number State | KY
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