Crider, Jack Byron

Crider, Jack Byron is an individual health care provider with primary practice located at 387 Town Mountain Rd Ste 202, Pikeville KY 41501-1640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Crider, Jack Byron can be contacted via phone (606) 437-1008.

Contact Information

Primary practice address
387 Town Mountain Rd Ste 202 Pikeville KY 41501-1640
Phone: (606) 437-1008
Fax: (606) 437-5040
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35982 Kentucky

Profile Details

NPI number 1437145091
LBN Legal business name Crider, Jack Byron
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Jun 12th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437145091 NPPES
Kentucky MEDICAID 64031610
Kentucky MEDICAID 1812140000

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