Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01072698A | IN |
N | 207X00000X | Orthopaedic Surgeon | MT193321 | PA |
N | 207XS0106X | Orthopaedic Hand Surgeon | 01072698A | IN |
NPI | 1285892877 |
---|---|
Provider Name | Dr. Nicholas E Crosby |
First Address | Indianapolis, IN 46260-2046 |
Second Address | Indianapolis, IN 46260-2046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 30/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000881662 | ANTHEM PROVIDER NUMBER (01) | IN |
000000941179 | ANTHEM PROVIDER NUMBER - HAND SURGERY (01) | IN |
201178720 | (05) | IN |
201178720 | MEDICAID HAND SURGERY (01) | IN |