Provider Demographics
NPI:1609914662
Name:CROOKS, MATTHEW TIMOTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:TIMOTHY
Last Name:CROOKS
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:PO BOX 2438
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-2438
Mailing Address - Country:US
Mailing Address - Phone:480-739-3081
Mailing Address - Fax:480-407-6520
Practice Address - Street 1:9023 E DESERT COVE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6714
Practice Address - Country:US
Practice Address - Phone:480-407-6400
Practice Address - Fax:480-407-6520
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42847207LP2900X, 208VP0014X, 208VP0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ504161Medicaid
AZ504161Medicaid