Individual
DR. KEITH PHILLIP CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
(503) 494-4997
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
(503) 494-4997
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
MD214291
OR
207R00000X
Internal Medicine Physician
294757-1
NY
207R00000X
Internal Medicine Physician
40990
KY
207R00000X
Internal Medicine Physician
MD214291
OR
208000000X
Pediatrics Physician
294757-1
NY
208000000X
Pediatrics Physician
40990
KY
208000000X
Pediatrics Physician
MD214291
OR
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
294757-1
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
40990
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03822786
—
NY
05
—
200882960
—
IN
05
—
7100025500
—
KY
Enumeration date
01/31/2007
Last updated
03/15/2023
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