Dr. Larry K Cruel
Primary Podiatric Medicine
4510 Office Park Dr
Jackson
, Mississippi 39206-6016
Dr. Larry K Cruel
Primary Podiatric Medicine
4510 Office Park Dr
Jackson
, Mississippi 39206-6016
(601) 981-8999
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About
Features
Specialties
- Primary Podiatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Larry K Cruel
- 4510 Office Park Dr
- Jackson, MS
- Zip : 39206-6016
- Fax : (601) 981-8999
- Phone : (601) 981-3001
Second Address
- Dr. Larry K Cruel
- 4510 Office Park Dr
- Jackson, MS
- Zip : 39206-6016
- Fax : (601) 981-8999
- Phone : (601) 981-3001
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FAQs
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Is Dr. Larry K Cruel a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213EP1101X | Primary Podiatric Medicine | 80152 | MS |
National Provider Identifier
| NPI | 1609996982 |
|---|---|
| Provider Name | Dr. Larry K Cruel |
| First Address | Jackson, MS 39206-6016 |
| Second Address | Jackson, MS 39206-6016 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/03/2007 |
| Last Update Date | 30/06/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00120141 | (05) | MS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.