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Individual

JODY R GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
(715) 387-5065
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
26376
WI
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
26376
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30590900
WI
Enumeration date
09/26/2006
Last updated
09/30/2010
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