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Individual

DR. CARL WENDELL ROSS SR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
410 LOUISIANA AVE, LAKE CHARLES, LA 70601-3230
(337) 439-4923
(337) 439-4410
Mailing address
1803 ENTERPRISE BLVD, LAKE CHARLES, LA 70601-6369
(337) 436-3881

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
04474R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1314111
LA
Enumeration date
05/18/2006
Last updated
07/08/2007
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