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1578530366

NPI Code Detail

MEDICARE: DR. MARK R CRUMP MD

MEDICARE: DR. MARK R CRUMP 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
1	207Q00000X	Family Medicine Physician	R3938	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	080046875	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13272000000	OTHER		QUALCHOICE
2	770008701	OTHER	AS	BREASTCARE
3	0000167046403	OTHER		UNITED HEALTH CARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5297056	OTHER		AETNA

General Provider Information

NPI Number	:	1578530366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK R CRUMP MD

Provider Business Mailing Address
First Line	:	PO BOX 757
Second Line	:
City	:	CAMDEN
State	:	AR
Zip	:	71711-0757
Country	:	US
Telephone Number	:	870-836-8101
Fax Number	:	870-837-6833

Provider Business Practice Location Address
First Line	:	353 CASH RD SW
Second Line	:
City	:	CAMDEN
State	:	AR
Zip	:	71701-3704
Country	:	US
Telephone Number	:	870-836-8101
Fax Number	:	870-837-6833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	10/03/2008

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Directions to “ DR. MARK R CRUMP MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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