Individual
NATHAN CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 227-2856
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MRO-2408
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/18/2024
Last updated
07/25/2024
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