Individual
TIERRA N CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2801 JACKSON AVE, POINT PLEASANT, WV 25550-1713
(304) 675-4107
(304) 675-4233
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27014
WV
Other
Enumeration date
05/08/2013
Last updated
08/22/2016
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