Crossroads Urology

Primary specialty

SpecialistTaxonomy code 174400000X

License

20046 Issued in MS

Legal business name

CROSSROADS UROLOGY

Practice address

785 Ohio Ave
Suite 1B
Clarksdale, MS 38614-6217

Phone

(662) 621-1880

Fax

(662) 621-1882

NPI assigned

Mar 26, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peggy Louise St.John

Title

Office Manager

Phone

(662) 621-1880

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1508038977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE",
            "address_2": "SUITE 1B",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146217",
            "telephone_number": "662-621-1880",
            "fax_number": "662-621-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE",
            "address_2": "SUITE 1B",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146217",
            "telephone_number": "662-621-1880",
            "fax_number": "662-621-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "ST.JOHN",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-621-1880"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MS",
            "license": "20046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cooper - Pang Eye Clinic, P.a.
• Lucy Cooper
• Tom Cooper, M.D.
• Robert Harding Corley, MS
• Leatrice R Cowan, CRNA
• Darlene Crumpton, PT
• Cummings Health Care Center
• Jacory Curb Sr., QMHP-CS
• Kushna K Damallie, MD
• Faith Darby

• Specialist in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.