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NPI Code Detail

MEDICARE: J R ROSS

MEDICARE: J R ROSS
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
1208800000XUrology Physician14833KY

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 : 1225084098
Entity Type Code : Individual
Provider Name (Legal Business Name) : J R ROSS
Provider Business Mailing Address
First Line : PO BOX 1959
Second Line :
City : OWENSBORO
State : KY
Zip : 42302-1959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1100 WALNUT ST
Second Line :
City : OWENSBORO
State : KY
Zip : 42301-2956
Country : US
Telephone Number : 270-684-9218
Fax Number : 270-684-0941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 03/16/2021

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Directions to “ J R ROSS ” Practice Location

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