Provider Demographics
NPI:1407900673
Name:CROSSWELL, JAMES J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:CROSSWELL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 CAMPEN RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516
Mailing Address - Country:US
Mailing Address - Phone:252-728-3875
Mailing Address - Fax:252-728-3594
Practice Address - Street 1:97 CAMPEN RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516
Practice Address - Country:US
Practice Address - Phone:252-728-3875
Practice Address - Fax:252-728-3594
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8925970Medicaid
NC8925970Medicaid
NC2336363Medicare PIN