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NPI Code Detail

MEDICARE: ERIC T GROSS MD

MEDICARE: ERIC T 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
12085R0001XRadiation Oncology Physician34036AZ
22085R0001XRadiation Oncology Physician46201CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Z237327OTHERAZPTAN

General Provider Information

NPI Number : 1336135516
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC T GROSS MD
Provider Business Mailing Address
First Line : PO BOX 6423
Second Line :
City : CHANDLER
State : AZ
Zip : 85246-6423
Country : US
Telephone Number : 480-855-2224
Fax Number : 480-398-8080
Provider Business Practice Location Address
First Line : 695 S DOBSON RD
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-5665
Country : US
Telephone Number : 480-821-2838
Fax Number : 480-821-9444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 03/30/2020

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