Provider Demographics
NPI:1275841512
Name:JOHN W. CROSBY, M.D., FACS
Entity Type:Organization
Organization Name:JOHN W. CROSBY, M.D., FACS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-770-2222
Mailing Address - Street 1:PO BOX 1107
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-1107
Mailing Address - Country:US
Mailing Address - Phone:334-770-2222
Mailing Address - Fax:334-770-2224
Practice Address - Street 1:145 SCOUTING CIR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-2540
Practice Address - Country:US
Practice Address - Phone:334-770-2222
Practice Address - Fax:334-770-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5663208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC70646Medicare UPIN