Individual
CHADWICK B. ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 765-3321
(580) 765-0597
Mailing address
1321 SW 116TH TER, OKLAHOMA CITY, OK 73170-4461
(405) 378-2150
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4329
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200069260A
—
OK
Enumeration date
02/22/2006
Last updated
07/08/2007
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