MEDICARE: DR. MICHAEL J. 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	174400000X	Specialist	C-8485	AR
2	2086X0206X	Surgical Oncology Physician	C8485	AR

General Provider Information

NPI Number	:	1861472565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J. CROSS M.D.

Provider Business Mailing Address
First Line	:	3901 PARKWAY CIR
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-6362
Country	:	US
Telephone Number	:	479-582-1000
Fax Number	:	479-582-5724

Provider Business Practice Location Address
First Line	:	3901 PARKWAY CIR
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-6362
Country	:	US
Telephone Number	:	479-587-2100
Fax Number	:	479-582-5724

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/05/2022

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