Crossett, Timothy Ray

Crossett, Timothy Ray is an individual health care provider with primary practice located at 620 Skyline Drive , Jackson TN 38301-3901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Crossett, Timothy Ray can be contacted via phone (731) 541-6174.

Contact Information

Primary practice address
620 Skyline Drive Jackson TN 38301-3901
Phone: (731) 541-6174
Fax: (731) 425-6274
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 19952 Tennessee

Profile Details

NPI number 1023085628
LBN Legal business name Crossett, Timothy Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated Apr 25th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023085628 NPPES
Other 3058645 BCBS
Other 4102190 BCBS
MEDICAID 3086620 BCBS
Other P00271014 BCBS
Other 300056937 BCBS
Other 300056951 BCBS
MEDICAID 3086628 BCBS
MEDICAID 3828137 BCBS

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