person
Mr. Kenneth Adams Crockett JR., PA-C
Medical Physician Assistant in Petoskey, Michigan
NPI 1053338830

Kenneth Adams Crockett JR. is a Medical Physician Assistant based in Petoskey, MI and is specialized in Medical. Kenneth Adams Crockett JR. practices in Petoskey, MI and has the professional credentials of PA-C. The NPI Number for Kenneth Adams Crockett JR. is 1053338830 and holds a License No. 5601001028 (Michigan).

The current practice location address for Kenneth Adams Crockett JR. is 1890 S Us Highway 131, Petoskey, MI and can be reached out via phone at 231-487-2000.

Location: 1890 S Us Highway 131, Petoskey, MI, 49770-8344
person
Provider Profile Details
NPI Number
1053338830
Provider Name
Kenneth Adams Crockett JR.
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1890 S Us Highway 131, Petoskey, MI, 49770-8344
Phone Number
231-487-2000
Fax Number
Provider Enumeration Date
07/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
KC001028 01 MI STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
1890 S Us Highway 131
City
State
Zip
49770-8344
Phone Number
231-487-2000
Fax Number
person
Provider Business Mailing Address Details
Address
1890 S Us Highway 131
City
State
Zip
49770-8344
Phone Number
231-487-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
5601001028 (Michigan)
Definition
Definition to come...
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