Provider Demographics
NPI:1396988960
Name:CROSBY, SAMUEL NEIL JR (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:NEIL
Last Name:CROSBY
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 1:2021 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2021
Mailing Address - Country:US
Mailing Address - Phone:615-324-1600
Mailing Address - Fax:615-284-2003
Practice Address - Street 1:2021 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2021
Practice Address - Country:US
Practice Address - Phone:615-324-1600
Practice Address - Fax:615-284-2003
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA257340207X00000X
TN48559207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I206465Medicare UPIN