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Specialty details in registry · Crocker, MO

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At a glance

307 Keeth Road, Crocker, MO 65452

NPPES record updated Sep 11, 2025. Public records can lag behind changes at a practice.

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Practice location

307 Keeth Road
Crocker, MO 65452

Professional details: NPI, taxonomy & registry record

NPI1790806545

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 385H00000X
Enumeration date: Apr 2, 2007
Record updated: Sep 11, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

320600000X

Specialty details in registry

385H00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

307 Keeth Road
Crocker, MO 65452

Phone: (573) 736-5603
Fax: (573) 736-2771

Mailing address

PO BOX 662

CROCKER, MO 654520662

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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