MEDICARE: BRUCE A 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	2085R0001X	Radiation Oncology Physician	35.056720	OH
2	2085R0001X	Radiation Oncology Physician	E7178	AR
3	2085R0001X	Radiation Oncology Physician	0431774	KS
4	2085R0203X	Therapeutic Radiology Physician	H4893	TX
5	2085R0001X	Radiation Oncology Physician	36469	MO

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

General Provider Information

NPI Number	:	1922090315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE A CROSS MD

Provider Business Mailing Address
First Line	:	PO BOX 11449
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4005
Country	:	US
Telephone Number	:	479-709-1924
Fax Number	:	479-709-7499

Provider Business Practice Location Address
First Line	:	1502 DODSON AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-5128
Country	:	US
Telephone Number	:	479-709-7190
Fax Number	:	479-709-7193

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	08/29/2023

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Directions to “ BRUCE A CROSS MD” Practice Location

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