GEORGE O CRISP JR. (NPI# 1063432151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063432151 |
| Entity Type | Individual |
| Full Name | GEORGE O CRISP JR. |
| Credential | M.D. |
| Practice Address |
2901 Roanoke Lane Tyler TX 75701-6523 |
| Practice Telephone | 9035663185 |
| Practice Fax Number | 9035667787 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-09-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | C3021 | TX | Allopathic & Osteopathic Physicians |
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
C3021 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | C3021 | TX | Allopathic & Osteopathic Physicians |
| N | 207PE0005X |
Emergency Medicine Specialization: Undersea and Hyperbaric Medicine |
C3021 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS BILLING NUMBER | 8CU187 | 01 |
| TX | TRICARE | TIN PLUS 042 | 01 |
| TX | 122540105 | 05 |
| Street Address |
2901 ROANOKE LANE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-6523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386261329 | Metabolic Innovations Inc | Internal Medicine | 1420 Wsw Loop 323 Ste 3, Tyler, TX 75701-9355 | 2020-06-25 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1235487638 | Jaaca Medical | Internal Medicine | 9334 Chisholm Trl, Tyler, TX 75703-0407 | 2012-08-16 |
| 1306040092 | Byron Seth Decamp | Internal Medicine | 619 S Fleishel Ave Ste 203, Tyler, TX 75701-2067 | 2007-06-14 |
| 1225128259 | Peter Pitonak | Internal Medicine | 703 E Fleishel Ave, Ste 4000, Tyler, TX 75701-2015 | 2006-10-13 |
| 1699867366 | Sharlet Slough Do | Internal Medicine | 6115 New Copeland Rd Ste 240, Tyler, TX 75703 | 2006-09-29 |
| 1346349297 | Cynthia J Shepherd | Internal Medicine | 5414 S Broadway, Tyler, TX 75703-1335 | 2006-09-21 |
| 1245339183 | Kevin Glen May | Internal Medicine | 6723 Highlands Ct, Tyler, TX 75703-0584 | 2006-09-21 |
| 1144329087 | David W Ball | Internal Medicine | 5407 New Copeland Rd Ste 200, Tyler, TX 75703 | 2006-09-21 |
| 1134132749 | David James Sloan | Internal Medicine | 1100 E Lake Street, Suite 240, Tyler, TX 75701 | 2006-08-14 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.