Healthcare Provider Details

I. General information

NPI: 1609914662
Provider Name (Legal Business Name): MATTHEW TIMOTHY CROOKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 W CHANDLER BLVD STE 100
CHANDLER AZ
85225-7539
US

IV. Provider business mailing address

17505 N 79TH AVE STE 304E
GLENDALE AZ
85308-8729
US

V. Phone/Fax

Practice location:
  • Phone: 602-648-5444
  • Fax: 602-772-3801
Mailing address:
  • Phone: 480-407-6400
  • Fax: 480-407-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number42847
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number42847
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number42847
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number42847
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: