Individual
DR. DANIEL WAYNE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1408 LAKE RIDGE SQ, JOHNSON CITY, TN 37601-7407
(423) 782-6848
(423) 283-4797
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
37770
TN
207Q00000X
Family Medicine Physician
MD0000037770
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515615
—
TN
05
—
1538163506
—
VA
05
—
3890168
—
TN
Enumeration date
06/08/2005
Last updated
10/09/2018
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