Provider Demographics
NPI:1326326588
Name:CROSS, JAMES DEWITT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DEWITT
Last Name:CROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:151 FARMINGTON AVE # RE52
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06156-0001
Mailing Address - Country:US
Mailing Address - Phone:860-273-5456
Mailing Address - Fax:860-273-0850
Practice Address - Street 1:151 FARMINGTON AVE # RE52
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06156-0001
Practice Address - Country:US
Practice Address - Phone:860-273-5456
Practice Address - Fax:860-273-0850
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT032159208D00000X
DCMD32127208D00000X
TXE9170208D00000X
MN22017208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice