Organization
DR. EDWARD FRANKLIN CROCKETT, III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD FRANKLIN CROCKETT III M.D. (PHYSICIAN)
(256) 764-1263
Entity
Organization
Contact information
Practice address
3502 CLOVERDALE RD, FLORENCE, AL 35633-1302
(256) 764-1263
(256) 764-9611
Mailing address
3502 CLOVERDALE RD, FLORENCE, AL 35633-1302
(256) 764-1263
(256) 764-9611
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
8871
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000012290
MEDICARE
—
05
—
000012290
—
AL
01
—
0046614
BCBS TENNESSEE
TN
01
—
12290
BCBS
AL
Enumeration date
08/24/2011
Last updated
08/24/2011
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