Organization
E.B. ROSS, JR MD-STEPHEN D GOODWIN, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN B ROSS JR. M.D. (PRESIDENT)
(504) 391-7650
Entity
Organization
Contact information
Practice address
120 MEADOWCREST ST, SUITE 200, GRETNA, LA 70056-5255
(504) 391-7650
(504) 394-7344
Mailing address
120 MEADOWCREST ST, SUITE 200, GRETNA, LA 70056-5255
(504) 391-7650
(504) 394-7344
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1146099
—
LA
05
—
1337994
—
LA
05
—
1379689
—
LA
Enumeration date
04/20/2007
Last updated
03/17/2009
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