Individual
DR. WILLIAM B CROSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
790 E 5TH ST, COQUILLE, OR 97423-1755
(541) 396-3111
(541) 396-5891
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4501
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
MD27659
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006216
—
OR
01
—
1407812365
GROUP NPI
OR
01
—
930635514
GROUP TAX ID
OR
01
—
R0000WFBTV
MEDICARE GROUP PIN
OR
Enumeration date
11/29/2006
Last updated
05/20/2013
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