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Individual

DR. JASON P. GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2460 WILLAMETTE ST, EUGENE, OR 97405-3169
(541) 683-3744
(541) 683-6672
Mailing address
2460 WILLAMETTE ST, EUGENE, OR 97405-3169
(541) 683-3744
(541) 683-6672

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301077983
MI
207W00000X
Ophthalmology Physician
Primary
MD153855
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104967123
MI
05
104983299
MI
01
180H27019
BCBS OF MICHIGAN
MI
01
382155439
COMMERCIAL INSURANCE
MI
05
500687131
OR
01
P00390624
PALMETTO GBA
MI
Enumeration date
09/22/2005
Last updated
12/30/2018
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