Provider Demographics
NPI:1508946153
Name:CROOK, ANGUS M (MD)
Entity Type:Individual
Prefix:
First Name:ANGUS
Middle Name:M
Last Name:CROOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 LEAKE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3731
Mailing Address - Country:US
Mailing Address - Phone:615-352-3846
Mailing Address - Fax:
Practice Address - Street 1:210 23RD AVE N
Practice Address - Street 2:SUITE 302
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1580
Practice Address - Country:US
Practice Address - Phone:615-329-4001
Practice Address - Fax:615-329-3858
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000001862207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN620931630OtherTAX ID NUMBER
TNB9522Medicare UPIN
TN3195079Medicare ID - Type Unspecified