Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 01091 | TN |
NPI | 1346219938 |
---|---|
Provider Name | Robert Kevin Cross |
First Address | Knoxville, TN 37934-2855 |
Second Address | Knoxville, TN 37934-2855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 15/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100040719 | PHP (01) | |
2240417 | UNITED HEALTHCARE (01) | |
3040215 | BLUE CROSS BLUE SHIELD (01) | |
3333333 | UMWA - THE FUNDS (01) | |
3356137 | CIGNA (01) | |
3599815 | (05) | TN |
410030909 | RAILROAD MEDICARE (01) | |
U55578 | (02) |