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General NPI Number Information
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NPI Number | 1114916756
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Entity Type | Individual
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Provider Name | WILLIAM ELSWORTH GROSS MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 5147 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32504-8771
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Country | US
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Telephone | 850-475-9025
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Fax | 850-494-7855
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Provider Business Mailing Address
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Address Line | 4205 BELFORT RD STE 4015
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City | JACKSONVILLE
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State | FL
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Zip | 32216-3623
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Country | US
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Telephone | 904-450-6063
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Fax | 904-539-4091
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME123489
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License Number State | FL
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