Basic Information
| Provider Information | |||||||||
| NPI: | 1942276241 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KROSS | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 770 PINE ST | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312012173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4786331710 | ||||||||
| FaxNumber: | 4786332316 | ||||||||
| Practice Location | |||||||||
| Address1: | 770 PINE ST STE 580 | ||||||||
| Address2: | |||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312017532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4786331710 | ||||||||
| FaxNumber: | 4786332316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2006 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 054585 | GA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.