Healthcare Provider Details

I. General information

NPI: 1760445241
Provider Name (Legal Business Name): GLENN ALLEN CROSBY II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GLENN ALLEN CROSBY II M.D.

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6373 N QUAIL HOLLOW RD
MEMPHIS TN
38120
US

IV. Provider business mailing address

PO BOX 22403
BELFAST ME
04915-4476
US

V. Phone/Fax

Practice location:
  • Phone: 901-683-4594
  • Fax: 901-683-0623
Mailing address:
  • Phone: 888-402-7256
  • Fax: 888-902-1099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number27889
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: