Healthcare Provider Details

I. General information

NPI: 1053670794
Provider Name (Legal Business Name): MATTHEW W CROZIER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2012
Last Update Date: 08/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 HULL RD STE 3301
GAINESVILLE FL
32607-4144
US

IV. Provider business mailing address

5015 TAYLOR KENTON
SAN ANTONIO TX
78240-5424
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7394
  • Fax:
Mailing address:
  • Phone: 512-507-2413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number17310
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD.36056
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: