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NPI Code Detail

MEDICARE: DR. JONATHON MICHAEL ROSS OD

MEDICARE: DR. JONATHON MICHAEL ROSS OD
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
1152W00000XOptometrist15382CA
2152W00000XOptometristOPT.007122OH

General Provider Information

NPI Number : 1710268206
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHON MICHAEL ROSS OD
Provider Business Mailing Address
First Line : 1664 NEIL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2333
Country : US
Telephone Number : 614-292-2020
Fax Number :
Provider Business Practice Location Address
First Line : 1664 NEIL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2333
Country : US
Telephone Number : 614-292-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2011
Last Update Date : 07/13/2023

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