Organization
CROSSOVER HEALTH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENETTE HUNTER (CREDENTIALING MANAGER)
(971) 500-2661
Entity
Organization
Contact information
Practice address
650 DITTMER AVE, PUEBLO, CO 81005-1212
(866) 271-3589
Mailing address
650 DITTMER AVE, PUEBLO, CO 81005-1212
(866) 271-3589
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193200000X
NONMEDICARE
—
Enumeration date
01/12/2026
Last updated
01/12/2026
Update your record
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