Provider Demographics
NPI:1043375959
Name:CROSS, JOSHUA AARON
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:AARON
Last Name:CROSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11700 W 2ND PL
Mailing Address - Street 2:ST ANTHONY MEDICAL PLAZA 2, SUITE 280
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1704
Mailing Address - Country:US
Mailing Address - Phone:720-321-8680
Mailing Address - Fax:
Practice Address - Street 1:11700 W 2ND PL
Practice Address - Street 2:ST ANTHONY MEDICAL PLAZA 2, SUITE 280
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1704
Practice Address - Country:US
Practice Address - Phone:720-321-8680
Practice Address - Fax:720-321-8681
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10184363AS0400X
NDPAC1023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
F89786Medicare UPIN