MEDICARE: DAVID L CROOKS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	296535	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376615492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L CROOKS MD

Provider Business Mailing Address
First Line	:	3041 ORCHARD PARK RD STE C
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-1238
Country	:	US
Telephone Number	:	716-674-3104
Fax Number	:	716-674-0666

Provider Business Practice Location Address
First Line	:	199 PARK CLUB LN STE 100
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-5269
Country	:	US
Telephone Number	:	716-332-6834
Fax Number	:	716-332-6856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	01/24/2023

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Directions to “ DAVID L CROOKS MD” Practice Location

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