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NPI Code Detail

MEDICARE: THOMAS W ROSS DO

MEDICARE: THOMAS W ROSS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician03119IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114997731
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS W ROSS DO
Provider Business Mailing Address
First Line : P.O. BOX 4557
Second Line :
City : DES MOINES
State : IA
Zip : 50305-4557
Country : US
Telephone Number : 515-280-7004
Fax Number : 515-280-9525
Provider Business Practice Location Address
First Line : 1000 E. ARMY POST RD
Second Line :
City : DES MOINES
State : IA
Zip : 50315-5939
Country : US
Telephone Number : 515-953-7560
Fax Number : 515-953-7549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 10/26/2012

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