Provider Demographics
NPI:1295799849
Name:CROLEY, JAMES EVERETT III (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EVERETT
Last Name:CROLEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:613 DEL PRADO BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2611
Mailing Address - Country:US
Mailing Address - Phone:239-772-2122
Mailing Address - Fax:239-772-8183
Practice Address - Street 1:613 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2611
Practice Address - Country:US
Practice Address - Phone:239-772-2122
Practice Address - Fax:239-772-8183
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2023-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME36184207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N78300Medicare PIN
D54458Medicare UPIN
FL36275ZMedicare ID - Type Unspecified