Ted J Crisman, MD is a
Family Medicine physician based in Fremont, Indiana. Ted J Crisman is licensed to practice in Indiana (license number 01030303A) and his current practice location is 401 S Broad St, Ste. B, Fremont, Indiana. He can be reached at his office (for appointments etc.) via phone at
(260) 495-9803.
NPI number for Ted J Crisman is 1437263944 and his current mailing address is 6920 Pointe Inverness Way Ste 200, Medpartners, Attn: Megan Fortney, Fort Wayne, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1437263944.
Physician's Profile
| Full Name | Ted J Crisman |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 401 S Broad St, Fremont, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1437263944
- Provider Enumeration Date: 08/19/2006
- Last Update Date: 01/17/2017
Medical Identifiers
Medical identifiers for Ted J Crisman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437263944 | NPI | - | NPPES |
| 100225590 | Medicaid | IN | |
| 3117175 | Medicaid | OH | |
| 000000329797 | Other | IN | ANTHEM BCBS OF INDIANA |
| 4048082 | Other | | AETNA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 01030303A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ted J Crisman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ted J Crisman, MD
6920 Pointe Inverness Way Ste 200, Medpartners, Attn: Megan Fortney,
Fort Wayne, IN 46804-7934
Ph: (260) 479-3515 | Ted J Crisman, MD
401 S Broad St, Ste. B,
Fremont, IN 46737-2114
Ph: (260) 495-9803 |
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