Provider Demographics
NPI:1326310822
Name:DANNY W CROSS OD PC
Entity Type:Organization
Organization Name:DANNY W CROSS OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:423-569-6822
Mailing Address - Street 1:18730 ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-2128
Mailing Address - Country:US
Mailing Address - Phone:423-569-6822
Mailing Address - Fax:423-569-6823
Practice Address - Street 1:18730 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2128
Practice Address - Country:US
Practice Address - Phone:423-569-6822
Practice Address - Fax:423-569-6823
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANNY W CROSS OD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN717OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty