Healthcare Provider Details

I. General information

NPI: 1922161900
Provider Name (Legal Business Name): ERNEST BARTON CROSS AUDIOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9369 HIGHWAY 19 N
COLLINSVILLE MS
39325-9219
US

IV. Provider business mailing address

9369 HIGHWAY 19 N
COLLINSVILLE MS
39325-9219
US

V. Phone/Fax

Practice location:
  • Phone: 601-626-0050
  • Fax: 601-626-0049
Mailing address:
  • Phone: 601-626-0050
  • Fax: 601-626-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA0999
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: