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Individual

DR. CLINTON ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2686 NEWBERRY STATION DR, LAKE CHARLES, LA 70611-3984
(337) 485-7600
(337) 485-7700
Mailing address
2686 NEWBERRY STATION DR, LAKE CHARLES, LA 70611-3984
(337) 485-7600

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
309749
LA
2084P0800X
Psychiatry Physician
ME161304
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063569648
GROUP NPI
05
119512900
FL
05
1551228
LA
05
2470299
LA
Enumeration date
06/14/2017
Last updated
04/07/2025
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