NPI 1538165287

Jay Anton Crockett, MD

Practitioner Colon & Rectal Surgery Physician Greenville, SC

Practice location

Address: 60 Bear Dr, Greenville, SC 29605-4458
Phone: (864) 269-5500
Fax: (864) 269-8568
Mailing address: 1 Independence PT STE 212, Greenville, SC 29615-4536

Registered specialties

Colon & Rectal Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208C00000X Licence 20317 (SC)

Other Colon & Rectal Surgery providers in South Carolina →

Registry record

NPI: 1538165287
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jun 2005
Record last updated: 2 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.