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1285636258

NPI Code Detail

MEDICARE: THOMAS GENE GROSS MD

MEDICARE: THOMAS GENE GROSS 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
1	2080P0207X	Pediatric Hematology & Oncology Physician	35075261	OH
2	2080P0207X	Pediatric Hematology & Oncology Physician	DR.0064358	CO
3	2080P0207X	Pediatric Hematology & Oncology Physician	71019	AZ

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

General Provider Information

NPI Number	:	1285636258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS GENE GROSS MD

Provider Business Mailing Address
First Line	:	2108 E THOMAS RD STE 130
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-0008
Country	:	US
Telephone Number	:	602-933-3124
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-7710
Country	:	US
Telephone Number	:	602-933-1000
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/25/2023

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Directions to “ THOMAS GENE GROSS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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