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Individual

DR. TRENT WADE CROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20405 ALBERTA ST, SUITE A, ONEIDA, TN 37841-3509
(423) 286-3400
(423) 286-3402
Mailing address
PO BOX 4937, ONEIDA, TN 37841-4937
(423) 286-3400
(423) 286-3402

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD0000038983
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4230308
BLUECROSS AND BLUESHIELD
TN
05
7100002510
KY
01
P00733990
MEDICARE RAILROAD
TN
Enumeration date
04/08/2006
Last updated
11/29/2017
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