Provider Demographics
NPI:1043265531
Name:CROSBY, GEORGE III (PT)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:CROSBY
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 RANDOLPH RD
Mailing Address - Street 2:STE 600
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1100
Mailing Address - Country:US
Mailing Address - Phone:704-342-0252
Mailing Address - Fax:704-342-1853
Practice Address - Street 1:1918 RANDOLPH RD
Practice Address - Street 2:STE 600
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1100
Practice Address - Country:US
Practice Address - Phone:704-342-0252
Practice Address - Fax:704-342-1853
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1955208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0775BOtherBCBS
NC186635OtherMEDCOST
NC807114OtherPARTNERS
NC2143186OtherMAMSI
NC4572849OtherAETNA