Basic Information
| Provider Information | |||||||||
| NPI: | 1386674760 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREGORY H CRISP, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7432 | ||||||||
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| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274170432 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1236 HUFFMAN MILL RD | ||||||||
| Address2: | SUITE 2000 | ||||||||
| City: | BURLINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272158700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365387180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 06/05/2013 | ||||||||
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| AuthorizedOfficialLastName: | CRISP | ||||||||
| AuthorizedOfficialFirstName: | GREGROY | ||||||||
| AuthorizedOfficialMiddleName: | HANNIBAL | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 3365387180 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.