Charles Prentice Crumpler, M.D.
Internal Medicine, Interventional Cardiology in Longview, TX. Individual provider (NPI-1).
NPI number1609986165
StatusActive
Last updated in NPPESNov 9, 2021
Details
- NPI
- 1609986165
- Entity type
- Individual (NPI-1)
- Name
- Charles Prentice Crumpler
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 30, 2006
- Certification date
- Nov 9, 2021
- Last updated
- Nov 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RI0011X | Internal Medicine, Interventional Cardiology | E6296 | TX | Yes |
Practice location
709 Hollybrook DrSuite 2301
Longview, TX 75605-2411
Phone 903-757-5804 · Fax 903-232-2889
Mailing address
Po Box 19036Belfast, ME 04915-4085
Phone 903-381-7263 · Fax 903-381-7269
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