Provider Demographics
NPI:1871568626
Name:GROSS, CRAIG G (MD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:G
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:7140 E ROSEWOOD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1346
Mailing Address - Country:US
Mailing Address - Phone:520-547-4900
Mailing Address - Fax:520-547-2435
Practice Address - Street 1:5301 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2805
Practice Address - Country:US
Practice Address - Phone:520-324-5461
Practice Address - Fax:520-324-1406
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25493207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ388787Medicaid
AZZ66868Medicare ID - Type Unspecified
AZ388787Medicaid