Individual
DR. JONATHAN BLAKE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1815 E HIGHLAND DR, JONESBORO, AR 72401-6118
(870) 931-2020
(870) 932-8004
Mailing address
3716 RIVIERA DR, JONESBORO, AR 72404-6874
(870) 934-8680
(870) 932-8004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2493
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141013722
—
AR
01
—
49648
AR BC/BS
AR
Enumeration date
06/15/2006
Last updated
05/11/2009
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