Individual
DR. STEVE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 PARKCLIFF DR, SUITE C, HOLIDAY ISLAND, AR 72631-9234
(479) 363-9174
(479) 363-9175
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E1025
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5K608
AR BLUE SHIELD #
AR
Enumeration date
11/01/2006
Last updated
07/09/2007
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