EDWARD FRANK CROCKER JR. (NPI# 1770519951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770519951 |
| Entity Type | Individual |
| Full Name | EDWARD FRANK CROCKER JR. |
| Credential | M.D. |
| Practice Address |
255 Baptist Blvd Suite 401 Columbus MS 39705-2011 |
| Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
| Practice Telephone | 6622442288 |
| Practice Fax Number | 6622442289 |
| Mailing Telephone | 9012273255 |
| Mailing Fax Number | 9012278591 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2015-02-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 17871 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05082097 | 05 | |
| AL | BCBS AL | 731-04786 | 01 |
| Street Address |
255 BAPTIST BLVD SUITE 401 |
| City | COLUMBUS |
| State | MS |
| Zip Code | 39705-2011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720087257 | Joon K Chang | Internal Medicine | 255 Baptist Blvd, Ste. 401, Columbus, MS 39705-2011 | 2005-07-18 |
| 1932551520 | Tiffany Warren | Nurse Practitioner | 255 Baptist Blvd, Columbus, MS 39705-2011 | 2016-07-06 |
| 1285068270 | Kelli Deanne King | Nurse Practitioner | 255 Baptist Blvd, Ste 401, Columbus, MS 39705-2011 | 2013-08-26 |
| 1124374673 | Margaret T Allgood | Nurse Practitioner | 255 Baptist Blvd, Suite 402, Columbus, MS 39705 | 2012-08-01 |
| 1629209952 | Michael A Berry | Surgery | 255 Baptist Blvd, Suite 307, Columbus, MS 39705-2011 | 2009-08-04 |
| 1851554539 | Baptist Memorial Health Services Inc of Mississippi | Internal Medicine | 255 Baptist Blvd, Suite 301, Columbus, MS 39705-2011 | 2008-07-03 |
| 1821268467 | Columbus Pulmonary Clinic | Internal Medicine | 255 Baptist Blvd, Ste 302, Columbus, MS 39705-2011 | 2008-03-11 |
| 1275719114 | Jerry L. Stennet, M.d. Pa D/b/a Columbus Surgery | Surgery | 255 Baptist Blvd, Suite 307, Columbus, MS 39705-2011 | 2008-01-10 |
| 1780702217 | J. Barton Williams M.d., P.a. | Specialist | 255 Baptist Blvd, Suite 305, Columbus, MS 39705-2011 | 2007-03-26 |
| 1871646323 | Lance E Busch | Internal Medicine | 255 Baptist Blvd, Suite 302, Columbus, MS 39705 | 2007-01-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255854527 | Kelly Christi Lovelace | Counselor | 428 24th Ave. North, Columbus, MS 39705 | 2017-07-19 |
| 1427505742 | National Vision, Inc. | Technician/Technologist | Bldg 160 Simler Blvd, Columbus, MS 39705 | 2016-09-02 |
| 1093165714 | Holly Murphy | Audiologist | 2430 4th Street North, Columbus, MS 39705 | 2016-06-14 |
| 1275951972 | Oleg Kalsow | Dentist | 300 Hospital Dr Ste 4, Columbus, MS 39705 | 2014-03-31 |
| 1982906509 | Gtrec, Inc. | Optometrist | 1913 Hwy. 45 N., Suite A, Columbus, MS 39705 | 2010-12-02 |
| 1295042919 | Emily Morgan Sesser | Nurse Practitioner | 4508 Hwy 45 N, Columbus, MS 39705 | 2010-09-01 |
| 1528298189 | Matthew Duane Williams | Internal Medicine | 2520 Fifth Street, North, Columbus, MS 39705 | 2009-07-16 |
| 1114156858 | Andrea Nicole Morris | Pediatrics | 2600 Fifth Street North, Columbus, MS 39705 | 2009-07-02 |
| 1124272307 | Paul J Scurti | Internal Medicine | 255 Baptist Blvd Ste 301, Columbus, MS 39705 | 2008-11-13 |
| 1073702171 | Heart To Heart Hospice of Columbus LLC | Hospice Care, Community Based | 2018 Hwy 45 N, Columbus, MS 39705 | 2007-10-15 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093091225 | Mohan Thanikachalam | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 311 N Drexel Ave, Columbus, OH 43209-1430 | 2011-11-02 |
| 1689966129 | Charles Victor Meckstroth | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3921 Bramford Rd, Columbus, OH 43220 | 2011-05-03 |
| 1265627301 | Ohiohealth Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 85 Mcnaughten Rd Ste 110, Columbus, OH 43213-5111 | 2007-09-12 |
| 1316047343 | Central Ohio Thoracic & Cardiovascular Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4236 E Broad St, Columbus, OH 43213-1279 | 2006-09-22 |
| 1114021797 | Columbus Cardiovascular and Thoracic Surgery Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1750 Churchview Ln, Columbus, OH 43220-4902 | 2006-09-12 |
| 1013945641 | Patrick Richard Wells | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3525 Olentangy River Rd Ste 5300, Columbus, OH 43214-3937 | 2006-06-30 |
| 1275570640 | Zulfikar Amin Sharif | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 285 E State St Ste 400, Columbus, OH 43215-4368 | 2006-06-02 |
| 1871583732 | Thomas Salamon | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 340 E Town St, Suite 8-500, Columbus, OH 43215-4600 | 2005-10-24 |
| 1154324895 | Hector A Dox | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 255 Baptist Blvd Ste 401, Columbus, MS 39705-2006 | 2005-05-25 |
| 1144854175 | Michael Patrick Vallely | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 452 W 10th Ave, Columbus, OH 43210-1240 | 2020-02-28 |
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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.