Healthcare Provider Details

I. General information

NPI: 1598879314
Provider Name (Legal Business Name): WILLIAM PRYOR CROOKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BILL PRYOR CROOKS MD

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 FIFTH STREET
COLLINS MS
39428
US

IV. Provider business mailing address

415 SOUTH 28TH AVENUE
HATTIESBURG MS
39401-7246
US

V. Phone/Fax

Practice location:
  • Phone: 601-765-4414
  • Fax: 601-765-9141
Mailing address:
  • Phone: 601-765-4414
  • Fax: 601-765-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13363
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: