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Individual

JOHN P ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
14104 N. EASTERN AVE. STE. E, EDMOND, OK 73013
(405) 340-1279
(405) 216-5089
Mailing address
1211 N SHARTEL AVE, STE 200, OKLAHOMA CITY, OK 73103-2425
(405) 235-8008
(405) 239-2403

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
13842
OK
208800000X
Urology Physician
MD-45914
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
$$$$$$$$$
BCBS
OK
05
100130030A
OK
Enumeration date
04/05/2006
Last updated
04/03/2019
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