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General NPI Number Information
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NPI Number | 1639478407
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Entity Type | Individual
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Provider Name | ADRIANNE J ROSS D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2011
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 1815 HIGHWAY 138 SE SUITE 600
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City | CONYERS
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State | GA
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Zip | 30013-2079
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Country | US
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Telephone | 770-922-8922
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Fax | 770-922-8956
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Provider Business Mailing Address
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Address Line | 470 E PHARR RD
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City | DECATUR
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State | GA
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Zip | 30030-4426
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Country | US
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Telephone | 770-922-8922
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Fax | 770-922-8956
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC006076
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD001201
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License Number State | GA
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