Individual
DR. THERESA J ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
112 SAINT JOHN ST, MONROE, LA 71201-7322
(318) 387-5681
(318) 322-9957
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
017867
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1342106
—
LA
Enumeration date
07/28/2006
Last updated
06/12/2019
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