Individual
CALEB CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3443 DICKERSON PIKE STE 190, NASHVILLE, TN 37207-2533
(615) 860-1580
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4901
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q076869
—
TN
Enumeration date
07/25/2017
Last updated
09/13/2022
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