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Individual

DR. JASON MITCHELL CROCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
733 W KEARNEY ST, SPRINGFIELD, MO 65803-1229
(417) 831-7575
(417) 831-7632
Mailing address
733 W KEARNEY ST, SPRINGFIELD, MO 65803-1229
(417) 831-7575
(417) 831-7632

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2001006863
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
143164
BLUE CROSS BLUE SHIELD
MO
01
1921532
FIRST HEALTH & CCN
MO
01
4400576
UNITED HEALTHCARE
MO
01
466725
HEALTHLINK
MO
05
755773900
MO
01
7825256
AETNA
MO
01
9168688
PRIVATE HEALTHCARE SYSTEM
MO
01
P00324028
RAILROAD MEDICARE
MO
Enumeration date
12/27/2005
Last updated
05/02/2012
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