Individual
DR. PATTY J CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9069 W THUNDERBIRD RD, PEORIA, AZ 85381
(623) 876-2800
(623) 876-2389
Mailing address
9069 W THUNDERBIRD RD, PEORIA, AZ 85381
(623) 876-2800
(623) 876-2389
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21076
AZ
207P00000X
Emergency Medicine Physician
J4757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105650902
—
TX
05
—
417643
—
AZ
01
—
J4757
STATE LICENSE
TX
Enumeration date
10/20/2005
Last updated
05/13/2019
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