Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD0000007087 | TN |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD0000007087 | TN |
NPI | 1255323382 |
---|---|
Provider Name | Dr. Hugh Don Cripps |
First Address | Smithville, TN 37166-2704 |
Second Address | Smithville, TN 37166-2704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 08/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002005378 | BCBS OF TN (01) | TN |
3151097 | (05) | TN |
B02342 | (02) | TN |