Individual
WILLIE F ROSS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
22 EXECUTIVE DR, TOMPKINSVILLE, KY 42167-7478
(270) 487-5741
(270) 487-9664
Mailing address
22 EXECUTIVE DR, TOMPKINSVILLE, KY 42167-7478
(270) 487-5741
(270) 487-9664
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
755DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000199526
BCBS
KY
01
—
03322
SPECTERA
KY
05
—
1205834587
—
KY
01
—
1386776169
MEDICARE CORP
KY
05
—
1386776169
—
KY
01
—
410049288
RAILROAD MEDICINE
—
01
—
5940
DAVIS VISION
KY
05
—
77007557
—
KY
01
—
8846
MEDICARE P-10
KY
Enumeration date
07/12/2005
Last updated
01/10/2017
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