PERCY VANDORN CROCKER (NPI# 1811990765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811990765 |
| Entity Type | Individual |
| Full Name | PERCY VANDORN CROCKER |
| Credential | M.D. |
| Practice Address |
610 Providence Park Dr E Bldg 2, Suite 203 Mobile AL 36695-4622 |
| Mailing Address |
2880 Dauphin St Mobile AL 36606-2457 |
| Practice Telephone | 2516332667 |
| Practice Fax Number | 2516332179 |
| Mailing Telephone | 2514731900 |
| Mailing Fax Number | 2514708943 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 00006625 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 000034516 | 05 | |
| AL | BLUE CROSS PROVIDER # | 51034516 | 01 |
| AL | BLUE CROSS AL PROV # | 51511130 | 01 |
| AL | BLUE CROSS AL PROV # | 51521765 | 01 |
| AL | AETNA PROVIDER # | 4006497 | 01 |
| AL | HEALTHSPRING PROVIDER # | C71188 | 01 |
| Street Address |
610 PROVIDENCE PARK DR E BLDG 2, SUITE 203 |
| City | MOBILE |
| State | AL |
| Zip Code | 36695-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790272250 | Elizabeth Brooke Stewart | Family Medicine | 610 Providence Park Dr E, Mobile, AL 36695-4622 | 2018-04-19 |
| 1598214116 | Carolyn Waddell | Physician Assistant | 610 Providence Park Dr E, Mobile, AL 36695-4622 | 2016-09-23 |
| 1265861355 | Alabama Providence Healthcare Services | Internal Medicine | 610 Providence Park Dr E, Bldg 1, Suite 101, Mobile, AL 36695-4622 | 2013-11-08 |
| 1083043178 | Alabama Providence Healthcare Services | Internal Medicine | 610 Providence Park Dr E, Bldg 1, Suite 102, Mobile, AL 36695-4622 | 2013-11-08 |
| 1811249444 | Dedra Snow | Pharmacist | 610 Providence Park Dr E, Mobile, AL 36695-4622 | 2012-10-05 |
| 1063770709 | Jonathan Michael Holmes | Pediatrics | 610 Providence Park Dr E, Ste. 201, Mobile, AL 36695-4622 | 2012-05-01 |
| 1548460116 | Andrea Lamendola Thompson | Audiologist | 610 Providence Park Dr E, Bldg. 2 Suite 202, Mobile, AL 36695-4622 | 2007-07-23 |
| 1255535662 | Providence Healthcare Services | Internal Medicine | 610 Providence Park Dr E, Bldg. 1 Suite 102, Mobile, AL 36695-4622 | 2007-06-12 |
| 1235146499 | Barbara M. Williams | Nurse Practitioner | 610 Providence Park Dr E, Bldg 1 Suite 102, Mobile, AL 36695-4622 | 2006-08-01 |
| 1255345369 | Stephen Anthony Kahalley | Internal Medicine | 610 Providence Park Dr E, Bldg 1 Suite 102, Mobile, AL 36695-4622 | 2006-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677596 | Linda Jean Hayes | Counselor | 2146 Carson Court, Mobile, AL 36695 | 2020-10-22 |
| 1205447836 | Restore Therapy Services, Ltd | Physical Therapist | 6720 Grejot Road, Mobile, AL 36695 | 2020-08-17 |
| 1437774999 | Nicholas Alan Brautigam | Chiropractor | 960 Schillinger Rd S, Suite D, Mobile, AL 36695 | 2020-06-10 |
| 1891320412 | R3 Counseling Solutions, LLC | Social Worker | 1110 Hillcrest Road, Suite 1b, Mobile, AL 36695 | 2020-03-04 |
| 1649800079 | Tondalaya Denise Mack | Home Health | 1450 Leroy Stevens Rd, Apt35, Mobile, AL 36695 | 2020-01-24 |
| 1801367107 | Tera Walters Therapy LLC | Pediatrics | 2523 D'iberville Drive North, Mobile, AL 36695 | 2018-12-12 |
| 1023595279 | Hall & Oates Pt West Mobile, LLC | Physical Therapist | 2351 Dawes Road, Mobile, AL 36695 | 2018-07-20 |
| 1679069116 | Oculo-facial Consultants | Ophthalmology | 610 Providence Park Dr E Bldg 2, Mobile, AL 36695 | 2018-07-09 |
| 1669964318 | Tina Highsmith | Hearing Instrument Specialist | 2344 Schillinger Rd S, Building #2 Ste A, Mobile, AL 36695 | 2018-05-30 |
| 1023533858 | Reach Pediatric Therapy | Speech-Language Pathologist | 12485 Jeff Hamilton Rd, Mobile, AL 36695 | 2017-08-14 |
| Find all providers in zip 36695 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1497862353 | James F. Benson Jr. | Otolaryngology | 6701 Airport Blvd Ste B123, Mobile, AL 36608-6775 | 2006-08-24 |
| 1083619332 | Wiley Hugh Justice | Otolaryngology | 5721 Usa North Dr, Hahn 1119, Mobile, AL 36688-0002 | 2005-06-14 |
| 1073517769 | Mark Richard Gacek | Otolaryngology | 100 Memorial Hospital Dr, Glw Annex Building, Ste. 3c, Mobile, AL 36608-1183 | 2005-06-09 |
| 1427051481 | Barry Lee Brown | Otolaryngology | 3701 Dauphin St, Mobile, AL 36608-1756 | 2005-05-24 |
| 1508424763 | Usa Health Physician Billing Services LLC | Otolaryngology | 1720 Center St Ste 103, Mobile, AL 36604-3300 | 2019-06-03 |
| 1093241671 | Alabama Providence Healthcare Services | Otolaryngology | 6701 Airport Blvd, Suite B123, Mobile, AL 36608-6705 | 2017-05-03 |
| 1083034367 | Kent L. Burton | Otolaryngology | 2880 Dauphin St, Mobile, AL 36606-2457 | 2014-04-24 |
| 1932449451 | Gacek Ear and Sinus Center LLC | Otolaryngology | 100 Memorial Hospital Dr, Glw Annex Building, Ste. 3c, Mobile, AL 36608-1183 | 2013-02-20 |
| 1932499076 | Brian Patrick Sullivan | Otolaryngology | 2880 Dauphin St, Mobile, AL 36606-2457 | 2011-04-11 |
| Find all providers in MOBILE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.