MEDICARE: DR. DAVID K ROSS MD

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	207Q00000X	Family Medicine Physician	0416213	KS

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

General Provider Information

NPI Number	:	1376516690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID K ROSS MD

Provider Business Mailing Address
First Line	:	PO BOX 1657
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66601-1657
Country	:	US
Telephone Number	:	785-295-5307
Fax Number	:	785-231-5991

Provider Business Practice Location Address
First Line	:	4646 NW FIELDING RD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66618-2588
Country	:	US
Telephone Number	:	785-286-4475
Fax Number	:	785-286-4423

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	03/18/2011

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