Dr. Kevin J. Gross O.D.
Optometrist in Scottsboro, AL(View on Map)
Full Name
Dr. Kevin J Gross O.D.
NPI Number
1861574626
NPI Type
Individual Provider
Gender
Male
Enumeration Date
10/20/2006
Specialties
(Taxonomies)Name
Code
152W00000X
152WC0802X
152WL0500X
152WX0102X
152WP0200X
152WS0006X
152WV0400X
Primary Taxonomy
Yes
No
No
No
No
No
No
Licenses
State
Alabama
License Number
S-554-TA-220
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 290
24020 JOHN T REID PKWY
City
Section
Scottsboro
State
AL
AL
Postal Code
35771-0290
35768-2855
Country
US
US
Telephone Number
(256) 574-3491
(256) 574-3491
Identifiers
Identifier
000059775
630711357
51059775
Identifier State
AL
AL
AL
Identifier Issuer
Unknown
TAX ID
BCBS
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 05/17/2021
Provider Address
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