JACK W CROSLAND (NPI# 1750373247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750373247 |
| Entity Type | Individual |
| Full Name | JACK W CROSLAND |
| Credential | MD |
| Practice Address |
2240 Adams Ave Ogden UT 84401-1511 |
| Practice Telephone | 8013935355 |
| Practice Fax Number | 8013944609 |
| Mailing Telephone | 8013935355 |
| Mailing Fax Number | 8013944609 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2011-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 159595-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MHB | 05391 | 01 | |
| TRICARE | 810680455A005 | 01 | |
| DMBA | 6273 | 01 | |
| PEHP | 68969 | 01 | |
| EDUCATORS | 870680455CRO | 01 | |
| ALTIUS | QM000053820 | 01 | |
| IHC | 107004879101 | 01 | |
| UT | 870680455007 | 05 |
| Street Address |
2240 ADAMS AVE |
| City | OGDEN |
| State | UT |
| Zip Code | 84401-1511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588660864 | Angela Epstein | Physician Assistant | 2240 Adams Ave, Ogden, UT 84401-1511 | 2005-06-22 |
| 1376108381 | Vanessa Jones | Nurse Practitioner | 2240 Adams Ave, Ogden, UT 84401-1511 | 2019-05-06 |
| 1437713450 | Brock D Rose | Dentist | 2240 Adams Ave, Ogden, UT 84401-1511 | 2019-04-25 |
| 1104365113 | Derek Petersen | Physician Assistant | 2240 Adams Ave, Ogden, UT 84401-1511 | 2017-02-23 |
| 1932650199 | Angeleena Harrison | Pharmacist | 2240 Adams Ave, Ogden, UT 84401-1511 | 2016-10-21 |
| 1023465564 | Heather D Larson | Physician Assistant | 2240 Adams Ave, Ogden, UT 84401-1511 | 2016-05-13 |
| 1346619285 | Amanda Gougler | Physician Assistant | 2240 Adams Ave, Ogden, UT 84401-1511 | 2015-09-22 |
| 1164825618 | Kathryn Evans | Physician Assistant | 2240 Adams Ave, Ogden, UT 84401-1511 | 2014-09-29 |
| 1427468248 | Jessica Griffin | Pharmacist | 2240 Adams Ave, Ogden, UT 84401-1511 | 2014-05-01 |
| 1679997779 | Joshua Tew | Physician Assistant | 2240 Adams Ave, Ogden, UT 84401-1511 | 2014-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376183558 | Vickie Fields | Counselor | 533 26th Street Ste 100, Ogden, UT 84401 | 2020-01-15 |
| 1063059939 | Gahc4 West Haven Ut Trs Sub, LLC | Assisted Living Facility | 3518 South 2625 West, West Haven, UT 84401 | 2019-12-10 |
| 1720631880 | Kelsey Askea | Student in an Organized Health Care Education/Training Program | 2261 Washington Blvd #102, Ogden, UT 84401 | 2019-07-18 |
| 1114579596 | James Edward Fenton Jr. | Nurse Practitioner | 2351 Grant Ave Ste 201, Ogden, UT 84401 | 2019-07-15 |
| 1689144248 | Crystal Hadley | Registered Nurse | 477 23rd Street, Ogden, UT 84401 | 2018-11-27 |
| 1336632215 | Michael David Leman | Registered Nurse | 1355 Hinckley Dr, Ogden, UT 84401 | 2018-06-14 |
| 1689926313 | Lotus Park Care Centers, LLC | Assisted Living Facility | 2639 W 3520 S, West Haven, UT 84401 | 2012-10-04 |
| 1770865776 | William M Gardiner | Social Worker | 2351 Grant, Suite 103, Ogden, UT 84401 | 2011-09-15 |
| 1043509888 | Absolute Vision | Optometrist | 4645 S. Midland Dr., Suite A, West Haven, UT 84401 | 2011-04-01 |
| 1629376496 | Chad Calkins | Counselor | 502 E 22nd St, Ogden, UT 84401 | 2011-03-03 |
| Find all providers in zip 84401 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548651540 | Kevin Larkin | Orthopaedic Surgery | 3038 Polk Ave, Ogden, UT 84403-0589 | 2015-02-11 |
| 1568800431 | Tristan Mele | Orthopaedic Surgery | 5405 S 500 E Ste 202, Ogden, UT 84405-7419 | 2013-06-12 |
| 1740592021 | Ihc Health Services Inc | Orthopaedic Surgery | 4403 Harrison Blvd, Ste 2600, Ogden, UT 84403-3277 | 2010-07-02 |
| 1750607891 | Sean Kuehn | Orthopaedic Surgery | 4403 Harrison Blvd, 2400, Ogden, UT 84403-3271 | 2010-04-14 |
| 1336396340 | Todd Ryan Grunander | Orthopaedic Surgery | 4403 Harrison Blvd, Suite 2400, Ogden, UT 84403-3271 | 2008-08-20 |
| 1568654697 | Dvs Orthopaedics, Inc. | Orthopaedic Surgery | 1486 E Skyline Dr, Ste 202, Ogden, UT 84405-4859 | 2007-08-13 |
| 1235349820 | Casey C Bachison | Orthopaedic Surgery | 4403 Harrison Blvd, Suite 2400, Ogden, UT 84403-3271 | 2007-05-23 |
| 1568590743 | Ogden Orthopaedic Specialists LLC | Orthopaedic Surgery | 6112 S 1550 E, Suite 202, Ogden, UT 84405-5608 | 2007-03-01 |
| 1548331358 | Neil Barton Callister | Orthopaedic Surgery | 4403 Harrison Blvd Ste 2400, Ogden, UT 84403-3297 | 2006-11-13 |
| 1659468106 | Howard S Richter | Orthopaedic Surgery | 4403 Harrison Blvd Ste 2400, Ogden, UT 84403-3297 | 2006-10-06 |
| Find all providers in OGDEN | ||||
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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.