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General NPI Number Information
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NPI Number | 1437291002
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Entity Type | Individual
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Provider Name | ROSS SOWELL DEAVOURS AUD
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 2112 BIENVILLE BLVD SUITE I
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3067
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Country | US
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Telephone | 228-818-9555
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Fax | 228-875-7493
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Provider Business Mailing Address
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Address Line | 2112 BIENVILLE BLVD SUITE I
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3067
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Country | US
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Telephone | 228-818-9555
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Fax | 228-875-7493
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A2055
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License Number State | MS
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