Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evan A. Crockett, MD

Individual provider Surgery Physician · NPI 1093448607

Evan A. Crockett, MD is a Surgery Physician in Salt Lake City, Utah. Works from 2 locations. Licensed in Texas and Utah.

Licensed in
TX, UT
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

30 N Mario Capecchi Dr Rm 4S100
Salt Lake City, UT 84112
Phone: (801) 581-2121
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3551 Roger Brooke Dr Bldg 3600, Fort Sam Houston, TX 78234-4504 — (907) 310-6267

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 13548246-1205 (UT)
Surgery Physician Taxonomy 208600000X · Licence BP10080668 (TX)

Record details

NPI number1093448607
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 1, 2022
Last updated in NPPESAugust 22, 2023
Certification dateJanuary 17, 2023

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