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General NPI Number Information
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NPI Number | 1891119913
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Entity Type | Organization
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Legal Business Name | SCOTT ROSSOW, DO, PC
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 2209 ASHLAND AVE
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-1932
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Country | US
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Telephone | 417-339-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 ASHLAND AVE
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-1932
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Country | US
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Telephone | 417-339-9800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT L. ROSSOW
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Credential | DO
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Telephone | 417-339-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2000168810
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License Number State | MO
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