MEDICARE: DR. LORNE M CROSS 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	174400000X	Specialist	G80144	CA
2	207L00000X	Anesthesiology Physician	MD27400	OR
3	207LA0401X	Addiction Medicine (Anesthesiology) Physician	MD27400	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00696847	OTHER	OR	RR MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548370463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORNE M CROSS MD

Provider Business Mailing Address
First Line	:	1011 COMMERCIAL ST NE STE 110
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-1036
Country	:	US
Telephone Number	:	503-983-9900
Fax Number	:	503-983-9899

Provider Business Practice Location Address
First Line	:	1011 COMMERCIAL ST NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-1049
Country	:	US
Telephone Number	:	503-983-9900
Fax Number	:	503-983-9899

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/05/2026

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Directions to “ DR. LORNE M CROSS MD” Practice Location

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