Individual
DR. LARA L. ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 HWY 19 N, MERIDIAN, MS 39307-5335
(601) 696-3232
(601) 696-3231
Mailing address
PO BOX 5166, MERIDIAN, MS 39302-5166
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18007
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009946185
—
AL
05
—
09124271
—
MS
01
—
731-04011
BLUE CROSS OF AL
—
01
—
P00113837
RAILROAD MEDICARE
—
Enumeration date
11/18/2005
Last updated
11/06/2013
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