Individual
MARK D ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
330 FRANKLIN RD, SCOTTSVILLE, KY 42164-8805
(270) 237-3871
(270) 237-5057
Mailing address
PO BOX 266, SCOTTSVILLE, KY 42164-0266
(270) 237-3871
(270) 237-5057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1244DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000053704
BCBS
KY
05
—
77012441
—
KY
Enumeration date
09/25/2006
Last updated
07/04/2008
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