Basic Information
| Provider Information | |||||||||
| NPI: | 1245673946 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRUM | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | ANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 96398 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731436398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009623303 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2380 N 400 E | ||||||||
| Address2: | |||||||||
| City: | NORTH LOGAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843416000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357139700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD2016-0081 | NM | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 6763480-1205 | UT | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.