Provider Demographics
NPI:1184622102
Name:CRUM, JOSEPH MURPHY SR (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MURPHY
Last Name:CRUM
Suffix:SR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 BOARDMAN CANFIELD ROAD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4237
Mailing Address - Country:US
Mailing Address - Phone:330-726-8164
Mailing Address - Fax:330-726-8652
Practice Address - Street 1:945 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE 11
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4237
Practice Address - Country:US
Practice Address - Phone:330-726-8164
Practice Address - Fax:330-726-8652
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH82000818111N00000X
OH818111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000131152OtherANTHEM PIN NUMBER
OH34137504600OtherOH BWC ID NUMBER
OH6253290001OtherDMEPOS
OH0419372Medicaid
OH341375046OtherFEDERAL TAX ID
OH000000131152OtherANTHEM PIN NUMBER