Provider Demographics
NPI:1396801452
Name:CROOK, DANIEL ESTES (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ESTES
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 1:6070 OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MER ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:71261-9510
Mailing Address - Country:US
Mailing Address - Phone:318-355-9564
Mailing Address - Fax:
Practice Address - Street 1:670 BELL HILL RD
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:LA
Practice Address - Zip Code:71040-2150
Practice Address - Country:US
Practice Address - Phone:318-927-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016324208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1397261Medicaid
LA5K157Medicare ID - Type Unspecified
LA1397261Medicaid