Provider Demographics
NPI:1023065661
Name:CRUMPLER, TAMMY N (MD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:N
Last Name:CRUMPLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SHADOWLINE DR
Mailing Address - Street 2:STE 201A
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5089
Mailing Address - Country:US
Mailing Address - Phone:828-264-6850
Mailing Address - Fax:264-264-0490
Practice Address - Street 1:336 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5008
Practice Address - Country:US
Practice Address - Phone:828-262-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD614802202085R0202X
NC5005009832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH35940Medicare UPIN
NC38878260Medicare ID - Type Unspecified