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Contact Information

REBECCA E CROCKETT, DO
5105 SOM CENTER ROAD
SUITE 201
WILLOUGHBY, OH44094
 Phone: 440-602-6710
 Fax: 440-269-8107
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for REBECCA E CROCKETT · (Female)

NPI Number 1376702241
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/05/2008
Last updated 03/03/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 34.009381
  • OH License # 58.001481
  • OH Medicaid 2867858
Hospital affiliation(s)
  • LAKE HEALTH - (Acute Care)
    7590 AUBURN ROAD
    CONCORD, OH 44077
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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