MEDICARE: DR. JEFFREY SCHUYLER CROSS M.D.

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
1	208600000X	Surgery Physician	31856	CO
2	208600000X	Surgery Physician	0425424	KS

Other Identifiers

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

General Provider Information

NPI Number	:	1205872587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY SCHUYLER CROSS M.D.

Provider Business Mailing Address
First Line	:	11700 W. 2ND PL
Second Line	:	SUITE #210
City	:	LAKEWOOD
State	:	CO
Zip	:	80228
Country	:	US
Telephone Number	:	720-321-8080
Fax Number	:	720-321-8081

Provider Business Practice Location Address
First Line	:	2460 W 26TH AVE
Second Line	:	SUITE 420-C
City	:	DENVER
State	:	CO
Zip	:	80211-5308
Country	:	US
Telephone Number	:	303-480-3565
Fax Number	:	303-480-3566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	08/08/2014

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