Dr. Samuel R. Crockett III, M.D.
Anesthesiology in Wilkes Barre, PA. Individual provider (NPI-1).
NPI number1669448957
StatusActive
Last updated in NPPESAug 12, 2020
Details
- NPI
- 1669448957
- Entity type
- Individual (NPI-1)
- Name
- Dr. Samuel R. Crockett III
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 27, 2006
- Certification date
- Aug 12, 2020
- Last updated
- Aug 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | MD073611L | PA | Yes |
Practice location
1000 E Mountain BlvdDept Of Anesthesia
Wilkes Barre, PA 18711-0027
Phone 570-826-7850 · Fax 570-826-7855
Mailing address
100 N Academy AveDanville, PA 17822-3034
Phone 570-271-6144 · Fax 570-271-6578
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