MEDICARE: DR. WILLIAM A J ALEXANDER JACKSON ROSS JR JR. 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
1	207X00000X	Orthopaedic Surgery Physician	52433	KY
2	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	047650	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	52433	OTHER	KY	KY MEDICAL LICENSE

General Provider Information

NPI Number	:	1245282037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM A J ALEXANDER JACKSON ROSS JR JR. M.D.

Provider Business Mailing Address
First Line	:	1920 NISKEY LAKE TRL SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-6326
Country	:	US
Telephone Number	:	404-344-9755
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 UPPER RIVERDALE RD SW STE 112
Second Line	:
City	:	RIVERDALE
State	:	GA
Zip	:	30274-2642
Country	:	US
Telephone Number	:	770-897-7874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	11/04/2025

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Directions to “ DR. WILLIAM A J ALEXANDER JACKSON ROSS JR JR. M.D.” Practice Location

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