Individual
DR. EVAN M ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
66 FINS RIGHT LN, HARDEEVILLE, SC 29927-1500
(440) 840-3826
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00448
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
DP198503
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001024410
ANTHEM
KY
05
—
201394010
—
IN
01
—
50111319
PASSPORT HEALTH PLAN
KY
05
—
7100417980
—
KY
01
—
P01673048
RAILROAD MEDICARE
KY
Enumeration date
04/29/2014
Last updated
09/04/2025
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