Organization
CROSSOVER HEALTH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENETTE HUNTER CPCS (LICENSING AND CREDENTIALING MANAGER)
(971) 500-2661
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY STE 200, LOUISVILLE, KY 40217-1413
(971) 500-2661
Mailing address
1169 EASTERN PKWY STE 200, LOUISVILLE, KY 40217-1413
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193200000X
MULTI SPECIALTY
—
Enumeration date
01/29/2025
Last updated
01/29/2025
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