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Contact Information

DEIDRE D CROCKER, MD
2390 WALL ST SE
CONYERS, GA30013-2150
 Phone: 770-922-5696
 Fax: 770-922-1065
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Public Health & General Preventive Medicine

2083P0901X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for DEIDRE D CROCKER · (Female)

NPI Number 1790947117
Status Active
Credentials MD
Entity Individual
Enumeration date 06/26/2008
Last updated 11/10/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 056811
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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