Individual
BRENDA J. ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 HIGHWAY 28, JASPER, TN 37347-3638
(423) 837-9500
(865) 539-8008
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD25147
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3036160
BCBS OF TENNESSEE
TN
05
—
3328361
—
TN
05
—
3328362
—
TN
01
—
4149824
BLUE CROSS
TN
01
—
P00284484
RAILROAD MEDICARE
TN
Enumeration date
06/27/2006
Last updated
11/19/2007
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