Individual
PHILIP M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 SW RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 472-7140
Mailing address
PO BOX 1750, GRANTS PASS, OR 97528-0148
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD16545
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053640
—
OR
Enumeration date
06/22/2006
Last updated
10/04/2007
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