Individual
DR. BOYD D. CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3555 S NATIONAL AVE, #302, SPRINGFIELD, MO 65807-7310
(417) 269-6868
(417) 269-6865
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3462
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2001019052
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146824
BLUE CROSS MO
—
05
—
205373509
—
MO
Enumeration date
08/28/2006
Last updated
11/10/2025
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