Individual
CHARLES S. ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3910 MIRROR POND WAY, EUGENE, OR 97408-5954
(541) 680-0361
(541) 200-6530
Mailing address
3910 MIRROR POND WAY, EUGENE, OR 97408-5954
(541) 680-0361
(541) 200-6530
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
DO10012
OR
207Q00000X
Family Medicine Physician
Primary
DO10012
OR
208D00000X
General Practice Physician
DO10012
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000188024
BCBS
OR
05
—
165878
—
OR
05
—
168395
—
OR
05
—
1740275932
—
OR
01
—
R103163
MEDICARE PART B
—
Enumeration date
09/14/2005
Last updated
05/21/2025
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