Individual
DR. RANDALL E ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1830 BLAKE AVE, ROARING FORK SURGICAL ASSOC, GLENWOOD SPRINGS, CO 81601
(970) 945-6533
(970) 945-3945
Mailing address
1830 BLAKE AVE, #202 ROARING FORK SURGICAL ASSOC, GLENWOOD SPRINGS, CO 81601
(970) 945-6533
(970) 945-3945
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
CO33497
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01334978
—
CO
01
—
1526353
UMWA
—
01
—
6640
BCBS
CO
01
—
841409708002
RMHMO
—
01
—
CO33497
RR MEDICARE
CO
01
—
P00175799
RR PIN
—
Enumeration date
12/04/2006
Last updated
05/19/2011
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