Mallori Crockett, ATC - Specialist/Technologist in Tuscaloosa, AL

Mallori Crockett, ATC is a Specialist/technologist - Athletic Trainer physician based in Tuscaloosa, Alabama. Mallori Crockett is licensed to practice in Alabama (license number 1537) and her current practice location is 801 6th Ave, Box 870308, Tuscaloosa, Alabama. She can be reached at her office (for appointments etc.) via phone at (205) 348-5832.

NPI number for Mallori Crockett is 1255738837 and her current mailing address is 801 6th Ave Box 870308, Tuscaloosa, Alabama. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1255738837.

Contact Information

Mallori Crockett, ATC
801 6th Ave, Box 870308,
Tuscaloosa, AL 35487-1409
(205) 348-5832
(205) 348-9770



Physician's Profile

Full NameMallori Crockett
GenderFemale
SpecialitySpecialist/technologist - Athletic Trainer
Location801 6th Ave, Tuscaloosa, Alabama
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1255738837
  • Provider Enumeration Date: 11/26/2014
  • Last Update Date: 12/22/2019

Medical Identifiers

Medical identifiers for Mallori Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255738837NPI-NPPES
2000003186OtherBOC #
1537OtherALLICENSURE #

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208100000XPhysical Medicine & Rehabilitation 1537 (Alabama)Secondary
2255A2300XSpecialist/technologist - Athletic Trainer 1537 (Alabama)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mallori Crockett is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mallori Crockett, ATC
801 6th Ave Box 870308,
Tuscaloosa, AL 35487-1409

Ph: (205) 348-3607
Mallori Crockett, ATC
801 6th Ave, Box 870308,
Tuscaloosa, AL 35487-1409

Ph: (205) 348-5832

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