Provider Demographics
NPI:1346219938
Name:CROSS, ROBERT KEVIN (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KEVIN
Last Name:CROSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11124 KINGSTON PIKE STE 127
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2855
Mailing Address - Country:US
Mailing Address - Phone:865-966-2020
Mailing Address - Fax:
Practice Address - Street 1:11124 KINGSTON PIKE STE 127
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2855
Practice Address - Country:US
Practice Address - Phone:865-966-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN01091152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
410030909OtherRAILROAD MEDICARE
3333333OtherUMWA - THE FUNDS
100040719OtherPHP
2240417OtherUNITED HEALTHCARE
3356137OtherCIGNA
3040215OtherBLUE CROSS BLUE SHIELD
TN3599815Medicaid
3333333OtherUMWA - THE FUNDS
TN3599815Medicaid
TN3599816Medicare PIN