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NPI Code Detail

MEDICARE: JOHN WILLIAM ROSS D.O.

MEDICARE:   JOHN WILLIAM ROSS  D.O.
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
1207VM0101XMaternal & Fetal Medicine PhysicianOS016351PA
2390200000XStudent in an Organized Health Care Education/Training Program
3207V00000XObstetrics & Gynecology PhysicianOS016351PA

General Provider Information

NPI Number : 1891961975
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN WILLIAM ROSS D.O.
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-1334
Country : US
Telephone Number : 570-214-5115
Fax Number : 570-214-5090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2008
Last Update Date : 08/13/2020

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