Provider Demographics
NPI:1871760587
Name:CRUM, JOSHUA REED (DO)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:REED
Last Name:CRUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4150
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-4150
Mailing Address - Country:US
Mailing Address - Phone:606-437-2400
Mailing Address - Fax:606-437-2401
Practice Address - Street 1:50 WEDDINGTON BRANCH RD STE C
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3296
Practice Address - Country:US
Practice Address - Phone:606-437-2401
Practice Address - Fax:606-437-2401
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY031172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYDC0133OtherRR MEDICARE
WV7200028000OtherWV MEDICAID
KY65941494Medicaid
KYDC0133OtherRR MEDICARE