Individual
DR. MELINDA ANN CROCKETT-MAPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
103374
MO
208M00000X
Hospitalist Physician
Primary
103374
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110228938
RAILROAD MEDICARE
MO
05
—
505773408
—
MO
Enumeration date
12/19/2006
Last updated
05/08/2017
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