Individual
DR. JOEL CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20400 LAKE CHABOT RD STE 202, CASTRO VALLEY, CA 94546-5315
(510) 881-7822
(510) 881-8552
Mailing address
5300 FAR HILLS AVE, DAYTON, OH 45429-2381
(937) 433-7536
(937) 433-9612
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2009016609
MO
207N00000X
Dermatology Physician
35.122221
OH
207N00000X
Dermatology Physician
Primary
A150539
CA
Other
Enumeration date
06/22/2009
Last updated
03/08/2024
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