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General NPI Number Information
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NPI Number | 1215382809
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Entity Type | Individual
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Provider Name | ASHLEIGH GUINN ROSS D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 2665 N DECATUR RD STE 730
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City | DECATUR
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State | GA
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Zip | 30033-6148
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Country | US
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Telephone | 404-508-4320
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Fax | 404-508-4112
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Provider Business Mailing Address
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Address Line | WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF 3640 COLONEL GLENN HWY
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City | DAYTON
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State | OH
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Zip | 45435-0001
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Country | US
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Telephone |
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 89091
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 89091
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License Number State | GA
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