Individual
DR. KENNETH EARL ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4 PONDER EXECUTIVE PLZ, HOUSE SPRINGS, MO 63051-3431
(636) 671-1563
(636) 671-3364
Mailing address
4 PONDER EXECUTIVE PLZ, HOUSE SPRINGS, MO 63051-3431
(636) 671-1563
(636) 671-3364
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R9C07
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241825306
—
MO
Enumeration date
11/29/2006
Last updated
05/29/2008
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