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NPI Code Detail

MEDICARE: MRS. MARION CHRISTINE ROSS L.C.S.W.

MEDICARE:  MRS. MARION CHRISTINE ROSS  L.C.S.W.
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
1104100000XSocial WorkerC2287MS

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 : 1992709570
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARION CHRISTINE ROSS L.C.S.W.
Provider Business Mailing Address
First Line : 133 EXECUTIVE DR STE A
Second Line :
City : MADISON
State : MS
Zip : 39110-8440
Country : US
Telephone Number : 601-665-2047
Fax Number : 800-476-4191
Provider Business Practice Location Address
First Line : 133 EXECUTIVE DR STE A
Second Line :
City : MADISON
State : MS
Zip : 39110
Country : US
Telephone Number : 601-665-2047
Fax Number : 800-476-4191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 07/13/2018

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Directions to “ MRS. MARION CHRISTINE ROSS L.C.S.W.” Practice Location

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