Provider Demographics
NPI:1720696297
Name:CROXTON, ANTHONY O
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:O
Last Name:CROXTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 MILE STRETCH DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34690-6060
Mailing Address - Country:US
Mailing Address - Phone:877-202-1191
Mailing Address - Fax:866-323-3781
Practice Address - Street 1:5304 MILE STRETCH DR
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-6060
Practice Address - Country:US
Practice Address - Phone:877-202-1191
Practice Address - Fax:866-404-2411
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator