=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154313765
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSS JAMES VALONE D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2005
-----------------------------------------------------
Last Update Date | 12/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 310 E WALNUT ST
-----------------------------------------------------
City | GARDEN CITY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67846-5572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-275-9752
-----------------------------------------------------
Fax | 620-275-4306
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1316 S MAIN ST
-----------------------------------------------------
City | CLARION
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50525-2019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-532-3406
-----------------------------------------------------
Fax | 515-532-9336
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 01647
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 02008123A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 05-44193
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------