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DR. KEITH THOMAS CROCKER DO NPI 1871597419


NPI Information

NPI: 1871597419
Provider Name: DR. KEITH THOMAS CROCKER, DO
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Individual
Address:
4300 CASCADE RD SE
STE 103
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 245-4513
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DR. Keith Thomas Crocker, DO is an orthopaedic surgery in Grand Rapids, MI. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. DR. Keith Thomas Crocker, DO NPI is 1871597419. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4300 CASCADE RD SE
STE 103
GRAND RAPIDS, MI
ZIP 49546-631
Phone: (616) 245-4513
Fax: (616) 245-4802

The enumeration date for this NPI number is 6/10/2005 and was last updated on 12/5/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery5101007635MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15413102MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
25413102OTHERMICHIGANBCBSM
31683584MEDICAIDMICHIGAN
4E26227MEDICARE UPINMICHIGAN
5P54539OTHERMICHIGANBCN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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