Robert Crockett Enterprise LLC
Organization Active NPI Foot & Ankle Surgery Podiatrist · Meridian, MS
NPI 1114201423 · NPPES record last updated Oct 5, 2011
Key facts
- NPI
- 1114201423
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 80193 (MS)
- Legal business name
- ROBERT CROCKETT ENTERPRISE LLC
- Practice address
- 2310 4TH St
Suite a
Meridian, MS 39301-5819 - Phone
- (601) 286-3745
- NPI assigned
- Oct 5, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert S Crockett, DPM
- Title
- Member
- Phone
- (601) 286-3745
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist |
213ES0103X | 80193 | MS | Yes |
Addresses
Primary practice location
2310 4TH St
Suite a
Meridian, MS 39301-5819
Mailing address
2310 4TH St
Suite a
Meridian, MS 39301-5819
Other names
- Magnolia DME
Other providers in Meridian, MS
- Andrew Mitchell Rinek
- Nancy H. Risher
- Ritzi RX Medical Wig Clinic
- Michelle L Roark
- John Roberge
- Robert J Berg, MD PA
- Colby Roberts
- Denise D Roberts
- Jamey D. Roberts
- Lasaundra Roberts
All providers in Meridian, MS · Foot & Ankle Surgery Podiatrist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.