Male or Other

Dr. Kevin D. Crismond D.O.

Hospitalist Physician in Jacksonville, FL(View on Map)

Full Name

Dr. Kevin Daniel Crismond D.O.

NPI Number

1164428447

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/22/2005

Specialties

(Taxonomies)

Code

208M00000X
207R00000X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

OS7896

Contact
Information

Purpose

Mailing
Location

Address

8773 PERIMETER PARK CT
8773 PERIMETER PARK CT

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32216-1165
32216-1165

Country

US
US

Telephone Number

(904) 493-3390
(904) 493-3390

Identifiers

Identifier

003174436A
152348
2610299-00
47222
45681
264319
110220060
E2746Y
2568802-00

Identifier State

GA
FL
FL
FL
FL
FL
FL
FL
FL

Identifier Issuer

GEORGIA MEDICAID
WELLCARE
MEDICAID - GROUP
FLORIDA BLUE
MEDICARE - GROUP
AVMED
RR MEDICARE
MEDICARE - INDIVIDUAL
MEDICAID - INDIVIDUAL

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/04/2016

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