| Organization Name: | CROSSROADS MEDICAL GROUP, LLC |
| NPI Number: | 1689981102 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY MATTHEW JAMES (OWNER/PHYSICIAN) |
| Mailing Address: | 1635 Highway 31 Nw Hartselle |
| State: | AL US |
| Postal Code: | 356404426 |
| Phone Number: | 2567476744 |
| Fax Number: | |
| NPI Enumeration Date: | 09/03/2010 |
| NPI Last Update Date: | 01/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |