Cross, Keith Phillip
Cross, Keith Phillip is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Cross, Keith Phillip can be contacted via phone (503) 494-7551.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239-3011
Phone: (503) 494-7551
Fax: (503) 494-4997
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 294757-1 | New York |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD214291 | Oregon |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 40990 | Kentucky |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 294757-1 | New York |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | MD214291 | Oregon |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD214291 | Oregon |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 40990 | Kentucky |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 40990 | Kentucky |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 294757-1 | New York |
Profile Details
| NPI number | 1528105194 |
|---|---|
| LBN Legal business name | Cross, Keith Phillip |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Mar 15th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528105194 | NPPES |
| Indiana | MEDICAID | 200882960 | |
| Indiana | MEDICAID | 7100025500 | |
| Indiana | MEDICAID | 03822786 |
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