Provider Demographics
NPI:1891954095
Name:CROSS, BRIAN WESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WESLEY
Last Name:CROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF OKLAHOMA DEPT OF UROLOGY
Mailing Address - Street 2:920 SL YOUNG BLVD, WP 2140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-0001
Mailing Address - Country:US
Mailing Address - Phone:405-271-6966
Mailing Address - Fax:
Practice Address - Street 1:920 SL YOUNG BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-1013
Practice Address - Country:US
Practice Address - Phone:405-271-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK31201208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty