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NPI Code Detail

MEDICARE: AMY W CROSS MD

MEDICARE: AMY W CROSS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianE2147AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013917905
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY W CROSS MD
Provider Business Mailing Address
First Line : 4301 W MARKHAM ST # 783
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-7101
Country : US
Telephone Number : 501-686-8000
Fax Number : 501-526-5148
Provider Business Practice Location Address
First Line : 1617 N WASHINGTON
Second Line :
City : MAGNOLIA
State : AR
Zip : 71753-2046
Country : US
Telephone Number : 870-234-7676
Fax Number : 870-562-2559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 10/01/2024

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