Provider Demographics
NPI:1134398084
Name:CROSS, ALAN D (DC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:D
Last Name:CROSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N ORACLE RD
Mailing Address - Street 2:236
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7732
Mailing Address - Country:US
Mailing Address - Phone:520-797-4177
Mailing Address - Fax:520-797-4177
Practice Address - Street 1:6700 N ORACLE RD
Practice Address - Street 2:236
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7732
Practice Address - Country:US
Practice Address - Phone:520-797-4177
Practice Address - Fax:520-797-4177
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDC5368Medicare PIN