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General NPI Number Information
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NPI Number | 1831161900
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Entity Type | Individual
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Provider Name | JEFFREY CRAIG CROSBY MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 807 S PONDEROSA ST
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City | PAYSON
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State | AZ
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Zip | 85541-5542
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Country | US
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Telephone | 928-472-1380
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Fax |
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Provider Business Mailing Address
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Address Line | 807 S. PONDEROSA
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City | PAYSON
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State | AZ
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Zip | 85541-5542
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Country | US
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Telephone | 928-472-1380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 28316
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License Number State | AZ
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