Healthcare Provider Details

I. General information

NPI: 1952970303
Provider Name (Legal Business Name): JAMES THOMAS GROSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL LN STE 145
DANVILLE IN
46122-2000
US

IV. Provider business mailing address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

V. Phone/Fax

Practice location:
  • Phone: 317-799-0192
  • Fax: 317-386-5633
Mailing address:
  • Phone: 317-837-5566
  • Fax: 317-718-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number01099891A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: