Larry K Cruel in Jackson - Primary Podiatric Medicine
Larry K Cruel - NPI 1609996982
Larry K Cruel is a Primary Podiatric Medicine in Jackson, Mississippi. Larry K Cruel practices all healthcare services and medical treatments related to Primary Podiatric Medicine. The NPI Number for Larry K Cruel is 1609996982. The last update date is 2008-06-30.
Larry K Cruel's current location address is 4510 Office Park Dr, Jackson, Mississippi. You can contact this provider via phone number 6019813001 and fax number 6019818999. The mailing address for Larry K Cruel is 4510 Office Park Dr, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry K Cruel |
|---|---|
| Address | 4510 Office Park Dr, Jackson, Mississippi |
| Phone Number | 6019813001 |
| Fax Number | 6019818999 |
| Sole Proprietor | Y |
| Credentials | DPM |
NPI Number Detail
| NPI Number | 1609996982 |
|---|---|
| Provider Enumeration Date | 2007-03-30 |
| Last Updated Date | 2008-06-30 |
Provider Mailing Address Detail
| Address | 4510 Office Park Dr |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392066016 |
| Phone Number | 6019813001 |
| Fax Number | 6019818999 |
Provider's Primary Taxonomy Detail
| Speciality | Primary Podiatric Medicine |
|---|---|
| Taxonomy | 213Ep1101X |
| Licence No | 80152 |
|
Definition: A doctor of podiatric medicine expert in general podiatry health services related to medical diagnoses and treatment of the foot, ankle and lower extremities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 120141 | MS | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Larry K Cruel by the Centers for Medicare & Medicaid Services?
The Larry K Cruel has been issued the NPI (National Provider Identifier) 1609996982, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Larry K Cruel's facilities are situated?
The facilities of Larry K Cruel are physically located at the following address: 4510 Office Park Dr, Jackson, MS, 392066016.
What is Larry K Cruel's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Larry K Cruel is Primary Podiatric Medicine, and the taxonomy classification code that categorizes this area of expertise is 213Ep1101X.
On what date did the Larry K Cruel receive the assignment of its 1609996982 from the Centers for Medicare & Medicaid Services?
The Larry K Cruel was issued its 1609996982 by the Centers for Medicare & Medicaid Services on 2007-03-30.
As of what date were the details related to Larry K Cruel most recently updated or revised?
The information pertaining to Larry K Cruel, including its address, specialty, and other relevant details, was last updated or revised on 2008-06-30.
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