Individual
JOSEPH GUARD ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 E MONTE PAINTER DRIVE, FAYETTEVILLE, AR 72703-4005
(479) 348-7170
(479) 587-1366
Mailing address
3232 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4005
(479) 587-1700
(479) 487-1366
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
C 5667
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100074280 A
—
OK
05
—
1790758761
—
MO
05
—
920005088
—
AR
Enumeration date
02/09/2006
Last updated
06/16/2020
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