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Search › Idaho › 208000000X

Theodore Gross

NPI 1922531508 · on the registry since 2017

Practice

Address
1100 Nw 12th St
Fruitland, ID 83619
Phone
(208) 452-6556
Organisation at this address
Snake River Pediatrics, Pc
Snake River Pediatrics, Pc
Snake River Pediatrics, Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
13

Registry record

Primary taxonomy
208000000X
208000000X
Also registered as
390200000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-08-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho