Basic Information
| Provider Information | |||||||||
| NPI: | 1043264765 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRIGLER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4711 SUNSET BLVD | ||||||||
| Address2: | STE 3 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290729151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033563609 | ||||||||
| FaxNumber: | 8033563941 | ||||||||
| Practice Location | |||||||||
| Address1: | 4711 SUNSET BLVD | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290729151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033563609 | ||||||||
| FaxNumber: | 8033563941 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 04/18/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 7662 | SC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | DC0371 | 01 | RAILROAD MEDICARE | OTHER | GP4000 | 05 | SC | MEDICAID | P00144230 | 01 | RAILROAD MEDICARE | OTHER | 201428891 | 01 | BCBS | OTHER | 4218965 | 01 | AETNA | OTHER |