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General NPI Number Information
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NPI Number | 1942294962
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Entity Type | Individual
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Provider Name | JOSEPH E CRUMP O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 1143 OAK RIDGE TPKE SUITE 103
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City | OAK RIDGE
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State | TN
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Zip | 37830-6422
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Country | US
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Telephone | 865-483-3031
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Fax | 865-483-7641
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Provider Business Mailing Address
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Address Line | 1143 OAK RIDGE TPKE SUITE 103
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City | OAK RIDGE
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State | TN
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Zip | 37830-6422
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Country | US
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Telephone | 865-483-3031
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Fax | 865-483-7641
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T718
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License Number State | TN
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