Healthcare Provider Details

I. General information

NPI: 1619934163
Provider Name (Legal Business Name): SCOTT T. CROFT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 S HOSPITAL DR
GLOBE AZ
85501-9447
US

IV. Provider business mailing address

5880 S HOSPITAL DR
GLOBE AZ
85501-9447
US

V. Phone/Fax

Practice location:
  • Phone: 928-425-3261
  • Fax:
Mailing address:
  • Phone: 928-425-3261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number1984
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: