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NPI Code Detail

MEDICARE: MR. GEORGE GREGORY ROSS M.D.

MEDICARE: MR. GEORGE GREGORY ROSS M.D.
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
1207R00000XInternal Medicine Physician0101043291VA
2207R00000XInternal Medicine PhysicianME136715FL

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 : 1164494449
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GEORGE GREGORY ROSS M.D.
Provider Business Mailing Address
First Line : PO BOX 2699
Second Line :
City : PENSACOLA
State : FL
Zip : 32513-2699
Country : US
Telephone Number : 850-835-1235
Fax Number : 850-835-4195
Provider Business Practice Location Address
First Line : 281 STATE HIGHWAY 20 E
Second Line :
City : FREEPORT
State : FL
Zip : 32439-3929
Country : US
Telephone Number : 850-835-1235
Fax Number : 850-835-4195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 09/11/2018

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