DR. JOSEPH WILLIAM CROOKSHANK III (NPI# 1710245964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710245964 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH WILLIAM CROOKSHANK III |
| Credential | M.D. |
| Practice Address |
1747 Imperial Blvd Lake Charles LA 70605-5362 |
| Mailing Address |
501 Dr Michael Debakey Dr Lake Charles LA 70601-5724 |
| Practice Telephone | 3377217236 |
| Practice Fax Number | 3377217237 |
| Mailing Telephone | 3377217236 |
| Mailing Fax Number | 3377217237 |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2018-03-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
302153 | LA | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
302153 | LA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1514 Jefferson Hwy, Brent House Suite 634, New Orleans, LA 701212429 | 5048423000 |
| Street Address |
1747 IMPERIAL BLVD |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70605-5362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487649091 | Staci Simon Boudreaux | Physician Assistant | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2005-09-20 |
| 1376168971 | Cody Gaupel | Student in an Organized Health Care Education/Training Program | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2020-06-10 |
| 1538703335 | Center for Orthopaedics and Spine LLC | Family Medicine | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-11-05 |
| 1013579150 | Bradley Lane Jimerson | Student in an Organized Health Care Education/Training Program | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-06-28 |
| 1912560541 | Haley Cook Cart | Physician Assistant | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-04-18 |
| 1174014534 | Susan Helms Cart | Occupational Therapist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2018-05-22 |
| 1679071161 | Ashley A Nix | Registered Nurse | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2018-01-30 |
| 1235584004 | Matthew Mccabe | Podiatrist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2016-04-29 |
| 1295100808 | Lauren Ashley Sexton | Specialist/Technologist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2015-12-08 |
| 1326422924 | Lance Henagan | Nurse Practitioner | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2015-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283606 | Kristin R Morris | Clinical Nurse Specialist | 1900 W. Gaythier Rd, Lake Charles, LA 70605 | 2020-10-21 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1053898403 | Heather Spallino Duplechain | Nurse Practitioner | 6713 Nelson Rd., Lake Charles, LA 70605 | 2018-07-27 |
| 1578057956 | Noor Deeb Weckerly | Nurse Practitioner | 6713 Nelson Rd, Lake Charles, LA 70605 | 2018-06-19 |
| 1861993354 | Therapy Works of Swla LLC | Physical Therapist | 4750 Lake Street, Lake Charles, LA 70605 | 2018-02-21 |
| 1669998852 | Amd Healthcare Lc, LLC | General Acute Care Hospital | 3730 Nelson Road, Lake Charles, LA 70605 | 2017-08-18 |
| 1619422474 | Kaitlyn Pinkerton | Specialist/Technologist | 800 E Mcneese St, Lake Charles, LA 70605 | 2016-08-22 |
| 1104274679 | Kelly Rogers | Counselor | 90 N. Luke 102l, Lafayette, LA 70605 | 2016-05-25 |
| 1548616220 | Lisa Monticello Snider | Neurological Surgery | 3297 Portrush Drive, Lake Charles, LA 70605 | 2016-05-11 |
| 1114387404 | Louisiana Dental Professionals, Donovan Dronet, Dds, A Professional De | Dentist | 4459 Nelson Rd, Suite 120, Lake Charles, LA 70605 | 2016-02-29 |
| Find all providers in zip 70605 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396926069 | Lake Charles Medical Services Family Practice Associates, LLC | Pain Medicine | 2750 Aster St, Lake Charles, LA 70601-8824 | 2007-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760025001 | Brain & Pain Care, LLC | Pain Medicine | 725 N Ashley Ridge Loop Ste 100, Shreveport, LA 71106-7233 | 2019-10-18 |
| 1548734213 | Urg-hab Surgical Specialists | Pain Medicine | 8558 Jefferson Hwy, Baton Rouge, LA 70809 | 2019-01-16 |
| 1831660596 | Injury Treatment Center of Louisiana, LLC | Pain Medicine | 15814 Professional Plz, Hammond, LA 70403-1453 | 2018-12-06 |
| 1538673694 | Advanced Pain Management, LLC | Pain Medicine | 6536 Lasalle Ave, Baton Rouge, LA 70806-7318 | 2017-11-28 |
| 1619417607 | Segura Wellness, LLC | Pain Medicine | 7039 Highway 190 East Service Rd, Suite C, Covington, LA 70433-4961 | 2017-02-24 |
| 1821431024 | Felman Institute for Wellness and Longevity | Pain Medicine | 455 East Airport Road, Baton Rouge, LA 70806 | 2013-04-08 |
| 1528203957 | Neuroscience & Pain Institute LLC | Pain Medicine | 50 Louis Prima Dr, Suite A, Covington, LA 70433 | 2008-12-15 |
| 1740495829 | Firas Hijazi Md Apmc | Pain Medicine | 2149 Augusta Dr, La Place, LA 70068-1711 | 2007-05-11 |
| 1760598726 | Melanie C. Firmin, Md Apmc | Pain Medicine | 1587 N Bolton Ave Ste 1200, Alexandria, LA 71303 | 2006-08-22 |
| 1700800828 | Kevin R Martinez | Pain Medicine | 4228 Houma Blvd Ste 510, Suite 510, Metairie, LA 70006-3015 | 2006-07-26 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70605 |
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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.