Crockett, Samuel R.
Crockett, Samuel R. is an individual health care provider with primary practice located at 1000 E Mountain Blvd Dept Of Anesthesia, Wilkes Barre PA 18711-0027. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Crockett, Samuel R. can be contacted via phone (570) 826-7850.Contact Information
Primary practice address
1000 E Mountain Blvd Dept Of Anesthesia
Wilkes Barre PA 18711-0027
Phone: (570) 826-7850
Fax: (570) 826-7855
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD073611L | Pennsylvania |
Profile Details
| NPI number | 1669448957 |
|---|---|
| LBN Legal business name | Crockett, Samuel R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2006 |
| Last updated | Aug 12th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669448957 | NPPES |
| Pennsylvania | MEDICAID | 001806174 |
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