Provider Demographics
NPI:1346907151
Name:CROSS, JAMES STEVEN JR
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:STEVEN
Last Name:CROSS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 1ST ST STE 404
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2297
Mailing Address - Country:US
Mailing Address - Phone:218-722-5513
Mailing Address - Fax:218-722-7173
Practice Address - Street 1:1000 E 1ST ST STE 404
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2265
Practice Address - Country:US
Practice Address - Phone:218-722-5513
Practice Address - Fax:218-722-7173
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13966363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant