Provider Demographics
NPI:1801854534
Name:CROOK, WILLIAM F (PA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:CROOK
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:239-465-4916
Mailing Address - Fax:
Practice Address - Street 1:4170 CEDAR BLUFF DR
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-7627
Practice Address - Country:US
Practice Address - Phone:231-487-2230
Practice Address - Fax:314-876-1722
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601004363363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
2057815640OtherBCBSM PIN
Q32369Medicare UPIN
0M09140010Medicare PIN
2057815640OtherBCBSM PIN