Provider Demographics
NPI:1073622452
Name:CROSBY, JAMES (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CROSBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1930 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5501
Mailing Address - Country:US
Mailing Address - Phone:303-935-9142
Mailing Address - Fax:303-934-7332
Practice Address - Street 1:9141 GRANT ST
Practice Address - Street 2:237
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4318
Practice Address - Country:US
Practice Address - Phone:303-452-1292
Practice Address - Fax:303-452-6225
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO209362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01209360Medicaid
CO01209360Medicaid
COCOA103572Medicare PIN