Individual
LARRY DENNIS CROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
Mailing address
514 E GREEN ST, GALLUP, NM 87301-6046
(505) 726-2407
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD09270
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD09270
OR
208M00000X
Hospitalist Physician
MD09270
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10334823
—
CO
05
—
277903
—
OR
05
—
415598
—
AZ
05
—
S0411
—
NM
Enumeration date
03/01/2006
Last updated
05/20/2008
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