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General NPI Number Information
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NPI Number | 1417900820
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Entity Type | Individual
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Provider Name | DENNIS MCCRACKEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 4524 N MARYVALE PKWY STE 140
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City | PHOENIX
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State | AZ
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Zip | 85031-1730
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Country | US
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Telephone | 623-440-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 4524 N MARYVALE PKWY STE 140
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City | PHOENIX
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State | AZ
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Zip | 85031-1730
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Country | US
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Telephone | 623-440-5424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0000023683
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 17027
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 23683
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License Number State | TN
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