Jay D Crockett (NPI# 1275577850, PAC ID# 1254463045) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1275577850 |
| PAC ID by PECOS | 1254463045 |
| Professional Enrollment ID | I20100714000342 |
| Full Name | Jay D Crockett |
| Organization Legal Name | MID-AMERICA RADIOLOGY INC |
| Address |
1500 State St Lexington MO 64067-1107 |
| Phone Number | 6602592203 |
| Gender | M |
| Medical School | UNIVERSITY OF HEALTH SCIENCES/CHICAGO MEDICAL SCHOOL |
| Graduation Year | 1997 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 0648302430 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 261320 | LAFAYETTE REGIONAL HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1500 State St, Lexington, MO 64067-1107 | 6602592203 | MID-AMERICA RADIOLOGY INC |
| Organization Legal Name | MID-AMERICA RADIOLOGY INC |
| Physicians | 1 |
| Street Address |
1500 STATE ST |
| City | LEXINGTON |
| State | MO |
| Zip | 64067-1107 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew E Nadler | Pain Management | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Adam J Henson | Emergency Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Brent S Carlson | Emergency Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Scott A Montgomery | Urology | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Peter T Phan | Emergency Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Rick D Bendorf | Certified Registered Nurse Anesthetist (crna) | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Sreedhar Rama | Internal Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Anne L Morgan | Emergency Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Rishi Grewal | Gastroenterology | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Emily Claire Larson | Rheumatology | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel R Mrosak | General Surgery | 1500 State St, Lexington, MO 64067-1107 | |
| Clinton Frederick Pickett | Orthopedic Surgery | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Dale H Wytock | Gastroenterology | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Simon Clark | Emergency Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Michael R Watts | Emergency Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Ryan B Utarnachitt | Gastroenterology | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Joseph B Eisenach | Gastroenterology | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| James E Lloyd | Certified Registered Nurse Anesthetist (crna) | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Ram Chandra | Family Medicine | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Avon C Coffman | Otolaryngology | Midwest Division-lrhc LLC | 1500 State St, Lexington, MO 64067-1107 |
| Find all physicians in zip 64067 | |||
| City | LEXINGTON |
| Zip Code | 64067 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | LEXINGTON + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Jay D Crockett.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.