Individual
DR. DIANE ELLEN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
749 OAKLEIGH AVE, GULFPORT, MS 39507-3809
(228) 896-3317
(228) 896-3314
Mailing address
2160 E PASS RD, SUITE D, GULFPORT, MS 39507-3801
(228) 896-3317
(228) 896-3314
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
09562
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010874
—
MS
Enumeration date
11/15/2006
Last updated
07/31/2014
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