Organization
INGRID K. ROSKOS, MD, AMPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INGRID KARIN ROSKOS MD (OWNER)
(985) 781-4848
Entity
Organization
Contact information
Practice address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Mailing address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.14651R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05927851
—
MS
05
—
1128767
—
LA
01
—
19D0964187
CLIA
LA
01
—
457756369
BCBS OF MS PROVIDER NUMBER
MS
01
—
4577563690
BCBS OF LA PROVIDER NUMBER
LA
Enumeration date
03/07/2007
Last updated
11/02/2011
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