Provider Demographics
NPI:1376779934
Name:CROSSLIN, THOMAS EUGENE III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EUGENE
Last Name:CROSSLIN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 GLEN COVE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4235
Mailing Address - Country:US
Mailing Address - Phone:207-921-5737
Mailing Address - Fax:207-921-5333
Practice Address - Street 1:4 GLEN COVE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4235
Practice Address - Country:US
Practice Address - Phone:207-921-5737
Practice Address - Fax:207-921-5333
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA240684208600000X
MEMD20101208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery