Provider Demographics
NPI:1285740928
Name:CROSS, RICHARD L (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:CROSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 NORTHPOINT BLVD
Mailing Address - Street 2:STE 118
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4055
Mailing Address - Country:US
Mailing Address - Phone:423-875-3800
Mailing Address - Fax:423-877-7226
Practice Address - Street 1:1920 NORTHPOINT BLVD
Practice Address - Street 2:STE 118
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4055
Practice Address - Country:US
Practice Address - Phone:423-875-3800
Practice Address - Fax:423-877-7226
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7363594OtherCIGNA
TN3676347Medicaid
TN0179851OtherBCBS OF TN
TN0179851OtherBCBS OF TN
TN3676347Medicare ID - Type Unspecified