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General NPI Number Information
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NPI Number | 1730208893
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Entity Type | Organization
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Legal Business Name | DOUGLAS CRUTCHER, PSC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 1210 KY HWY 36E
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City | CYNTHIANA
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State | KY
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Zip | 41031-7490
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Country | US
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Telephone | 859-277-9436
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Fax | 859-277-1765
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Provider Business Mailing Address
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Address Line | 870 CORPORATE DR SUITE 400
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City | LEXINGTON
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State | KY
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Zip | 40503-5416
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Country | US
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Telephone | 859-277-9436
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Fax | 859-277-1765
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DOUGLAS C CRUTCHER
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Credential | M.D.
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Telephone | 859-277-9436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 22755
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License Number State | KY
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