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Organization
CROCKETT CHIROPRACTIC, PC
Active
Organization
CROCKETT CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON MITCHELL CROCKETT D.C. (PRESIDENT)
(417) 831-7575
Entity
Organization
Contact information
Practice address
733 W KEARNEY ST, SPRINGFIELD, MO 65803-1229
(417) 831-7575
(417) 831-7632
Mailing address
733 W KEARNEY ST, SPRINGFIELD, MO 65803-1229
(417) 831-7575
(417) 831-7632
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2001006863
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143164
BLUE CROSS BLUE SHIELD
MO
01
—
1921532
FIRST HEALTH & CCN
MO
01
—
4400576
UNITED HEALTHCARE
MO
01
—
466725
HEALTHLINK
MO
01
—
472348
BLUE CHOICE OF KANSAS
KS
05
—
755773900
—
MO
01
—
7825256
AETNA
MO
01
—
9168688
PRIVATE HEALTHCARE SYSTEM
MO
01
—
DE9027
RAILROAD MEDICARE
MO
Enumeration date
12/27/2005
Last updated
04/30/2012
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