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Individual

DR. EDWARD FRANKLIN CROCKETT III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1245 WESTGATE PKWY, DOTHAN, AL 36303-2151
(334) 793-9595
(334) 794-8153
Mailing address
1245 WESTGATE PKWY, DOTHAN, AL 36303-2151
(334) 793-9595
(334) 794-8153

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8871
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000012290
AL
Enumeration date
07/12/2006
Last updated
07/21/2016
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