# DR. JORDAN S ROSS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1073583035
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 3119 | AZ | — |
| 207Q00000X | Family Medicine Physician | 3119 | AZ | Yes |

## Other

- **Enumeration date:** 01/24/2006
- **Last updated:** 05/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3119 | STATE LICENSE | AZ |