Individual
DOUGLAS R ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-6000
(785) 354-5004
Mailing address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-6000
(785) 354-5004
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
04-25144
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046953
BLUE CROSS BLUE SHIELD KS
—
05
—
100164820B
—
KS
01
—
613230
FIRSTGUARD HEALTH PLAN
—
Enumeration date
09/26/2006
Last updated
06/10/2014
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