Individual
DR. KENNETH LEE CROSBY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(434) 200-5047
Mailing address
5220 GREENS DAIRY RD, RALEIGH, NC 27616-4612
(919) 256-3576
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
200101032
NC
2085R0202X
Diagnostic Radiology Physician
0101271324
VA
2085R0202X
Diagnostic Radiology Physician
Primary
200101032
NC
2085R0202X
Diagnostic Radiology Physician
85214
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013018159
—
NC
01
—
NC6987H
NC MEDICARE PTAN
NC
Enumeration date
09/25/2006
Last updated
04/17/2024
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