Individual provider · NPI-1

Dr. Matthew James Crisp, M.D., Ph.D.

Internal Medicine · Festus, MO

NPI number1710337274
StatusActive
Last updated in NPPESJul 8, 2019

Details

NPI
1710337274
Entity type
Individual (NPI-1)
Name
Dr. Matthew James Crisp
Credential
M.D., Ph.D.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 15, 2016
Last updated
Jul 8, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine2016018189MOYes

Practice location

1400 Us Highway 61
Festus, MO 63028-4100

Phone 636-933-1000

Mailing address

1400 Us Highway 61
Festus, MO 63028-4100

Phone 636-933-1000

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