Provider Demographics
NPI:1306183058
Name:KRISPINSKY, ANDREW JOHN
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:KRISPINSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-8511
Mailing Address - Country:US
Mailing Address - Phone:286-311-8528
Mailing Address - Fax:
Practice Address - Street 1:243 JONES COVE RD
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-9483
Practice Address - Country:US
Practice Address - Phone:828-627-9616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-02112207ZD0900X, 207N00000X
VA0101256702208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice