Theodore Gross

NPI #1922531508 in Fruitland, Idaho

Provider Information

NPI Number: 1922531508
Entity Type: Individual
Name: Theodore Gross
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Enumeration Date: Apr 10, 2017
Last Updated: Aug 5, 2025

Practice Location

Address: 1100 NW 12TH ST
City: Fruitland
State: Idaho
ZIP Code: 83619-5040
Phone: (208) 452-6556

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Pediatrics	208000000X	Primary

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Organizations

Provider Name	Specialty	City
Snake River Pediatrics, PC	Pediatrics	Fruitland	AI Deep Dive

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