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Individual

SIDNEY S CROSBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
227 HOSPITAL DR, JACKSON, AL 36545-2423
(251) 246-4446
(251) 246-5111
Mailing address
PO BOX 639, JACKSON, AL 36545-0639
(251) 246-4446
(251) 246-5111

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10439
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051037556
AL
01
1750393682
GROUP NPI #
AL
05
1750393682
AL
05
1982604948
AL
01
37556
MEDICARE PROVIDER #
AL
05
529700760
AL
05
541003926
AL
05
541392602
AL
01
F712
MEDICARE GROUP ID
AL
Enumeration date
07/29/2005
Last updated
05/25/2009
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