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General NPI Number Information
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NPI Number | 1326099862
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Entity Type | Individual
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Provider Name | BRADLEY T CROSS O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 44332 STERLING HWY STE 52
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City | SOLDOTNA
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State | AK
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Zip | 99669-8065
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Country | US
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Telephone | 907-260-9199
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Fax | 907-260-9189
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Provider Business Mailing Address
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Address Line | 44332 STERLING HWY STE 52
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City | SOLDOTNA
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State | AK
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Zip | 99669-8065
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Country | US
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Telephone | 907-260-9199
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Fax | 907-260-9189
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 326
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 009830
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License Number State | NY
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