Provider Demographics
NPI:1932639572
Name:CROSS, BRADLEY ERIC (DO)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:ERIC
Last Name:CROSS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1401 E VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4245
Mailing Address - Country:US
Mailing Address - Phone:918-421-8440
Mailing Address - Fax:918-421-8750
Practice Address - Street 1:1401 E VAN BUREN AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4245
Practice Address - Country:US
Practice Address - Phone:918-421-8440
Practice Address - Fax:918-421-8750
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine