Healthcare Provider Details

I. General information

NPI: 1700106978
Provider Name (Legal Business Name): DANIEL CROZIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 PARK CENTRAL SQ APT 608
SPRINGFIELD MO
65806-1351
US

IV. Provider business mailing address

138 PARK CENTRAL SQ APT 608
SPRINGFIELD MO
65806-1351
US

V. Phone/Fax

Practice location:
  • Phone: 608-239-7986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2012008169
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: