Provider Demographics
NPI:1841260627
Name:CROSBY, CAROLYN S (MD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:S
Last Name:CROSBY
Suffix:
Gender:F
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:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1327
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:238 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-5803
Practice Address - Country:US
Practice Address - Phone:603-279-7464
Practice Address - Fax:603-279-8467
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9885207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2496990OtherCIGNA
NH0102759YPNH01OtherANTHEM
NH3412774OtherAETNA
NH711587OtherHARVARD PILGRIM HLTHCARE
NH80004315Medicaid
NH383801OtherMVP
NHRE4315Medicare ID - Type Unspecified