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

Mr. Kenneth Adams Crockett Jr., PA-C

Individual provider Medical Physician Assistant · NPI 1053338830

Mr. Kenneth Adams Crockett Jr., PA-C is a Medical Physician Assistant in Petoskey, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1890 S US Highway 131 Ste 4
Petoskey, MI 49770-8344
Phone: (231) 487-2000
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601001028 (MI)

Record details

NPI number1053338830
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 16, 2006
Last updated in NPPESApril 18, 2008

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