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Organization
INGRID K. ROSKOS, MD, AMPC
Active
Organization
INGRID K. ROSKOS, MD, AMPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INGRID KARIN ROSKOS MD (OWNER)
(985) 781-4848
Entity
Organization
Contact information
Practice address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Mailing address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.14651R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05927851
—
MS
05
—
1128767
—
LA
01
—
19D0964187
CLIA
LA
01
—
457756369
BCBS OF MS PROVIDER NUMBER
MS
01
—
4577563690
BCBS OF LA PROVIDER NUMBER
LA
Enumeration date
03/07/2007
Last updated
11/02/2011
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