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NPI Code Detail

MEDICARE: CHARLES D CRIGGER MD

MEDICARE: CHARLES D CRIGGER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician13857WV
2207Y00000XOtolaryngology Physician35.120185OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386640662
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES D CRIGGER MD
Provider Business Mailing Address
First Line : 90 JACKSON PIKE
Second Line :
City : GALLIPOLIS
State : OH
Zip : 45631-1560
Country : US
Telephone Number : 740-446-5135
Fax Number : 740-446-5958
Provider Business Practice Location Address
First Line : 90 JACKSON PIKE
Second Line :
City : GALLIPOLIS
State : OH
Zip : 45631-1560
Country : US
Telephone Number : 740-446-5135
Fax Number : 740-446-5958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 08/07/2014

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