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ROBERT CROCKETT ENTERPRISE LLC

Surgery, Foot & Ankle

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Contact Information

ROBERT CROCKETT ENTERPRISE LLC
2310 4TH ST
SUITE A
MERIDIAN, MS  39301-5819
 Phone: 601-286-3745
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

 213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ROBERT CROCKETT ENTERPRISE LLC

NPI Number 1114201423
LBN Legal business name ROBERT CROCKETT ENTERPRISE LLC
Authorized official ROBERT CROCKETT - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/05/2011
Last updated 10/05/2011 - About 15 years ago
Identifiers
MS License # 80193
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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