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Individual

DR. JACK A ROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-2294
Mailing address
PO BOX 560977, ROCKLEDGE, FL 32956-0977
(321) 639-2404

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
78800
CT
207L00000X
Anesthesiology Physician
ME38787
FL
261Q00000X
Clinic/Center
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
068638700
FL
Enumeration date
10/17/2006
Last updated
07/31/2024
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