Crump, Mark A
Crump, Mark A is an sole proprietor health care provider with primary practice located at 708 S 8Th St , Griffin GA 30224-4827. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Crump, Mark A can be contacted via phone (770) 228-5402.Contact Information
Primary practice address
708 S 8Th St
Griffin GA 30224-4827
Phone: (770) 228-5402
Fax: (770) 412-6917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 28957 | Georgia |
Profile Details
| NPI number | 1558362897 |
|---|---|
| LBN Legal business name | Crump, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Sep 26th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558362897 | NPPES |
| Georgia | Other | 581936002 | TAX ID |
| Georgia | MEDICAID | 000332758A | TAX ID |
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