Crocker, Percy Vandorn

Crocker, Percy Vandorn is an individual health care provider with primary practice located at 610 Providence Park Dr E Bldg 2, Suite 203, Mobile AL 36695-4622. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Crocker, Percy Vandorn can be contacted via phone (251) 633-2667.

Contact Information

Primary practice address
610 Providence Park Dr E Bldg 2, Suite 203 Mobile AL 36695-4622
Phone: (251) 633-2667
Fax: (251) 633-2179
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 00006625 Alabama

Profile Details

NPI number 1811990765
LBN Legal business name Crocker, Percy Vandorn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Nov 19th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811990765 NPPES
Alabama MEDICAID 000034516
Alabama Other C71188
Alabama Other 4006497
Alabama Other 51034516
Alabama Other 51511130
Alabama Other 51521765

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