Individual
DR. KERRY W ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
127 CRESTVIEW PARK DR, DICKSON, TN 37055-2850
(615) 441-4472
(615) 441-4507
Mailing address
127 CRESTVIEW PARK DR, DICKSON, TN 37055-2850
(615) 446-5121
(615) 446-1357
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD32022
TN
208000000X
Pediatrics Physician
MD32022
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110236216
RAILROAD MEDICARE PIN
—
05
—
3877243
—
TN
01
—
4024935
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
05/26/2005
Last updated
04/28/2022
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