Individual
DR. DAVID J. CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4545 E CHANDLER BLVD, SUITE 202, PHOENIX, AZ 85048-7645
(480) 659-2330
(480) 659-2544
Mailing address
2222 E HIGHLAND AVE, SUITE 204, PHOENIX, AZ 85016-4872
(602) 264-4834
(602) 254-5178
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
49273
AZ
207YP0228X
Pediatric Otolaryngology Physician
Primary
49273
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
922449
—
AZ
Enumeration date
11/10/2008
Last updated
02/15/2016
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