Individual
DR. MICHAEL AMBROSE CRONKLETON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(563) 421-1000
Mailing address
1505 OLD FREEPORT CT, BETTENDORF, IA 52722-3898
(563) 355-2811
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
22401
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1195909-0215
—
IA
Enumeration date
03/25/2006
Last updated
07/08/2007
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