Organization
KELLY G ROSS OD PA
Active
Other names
ross eye care center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY ROSS O.D. (OWNER)
(870) 886-2632
Entity
Organization
Contact information
Practice address
1014 W MAIN ST, WALNUT RIDGE, AR 72476-1004
(870) 886-2632
(870) 886-1514
Mailing address
1014 W MAIN ST, P.O. BOX 349, WALNUT RIDGE, AR 72476-1004
(870) 886-2632
(870) 886-1514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2485
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167096722
—
AR
01
—
5F267
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/28/2006
Last updated
03/05/2009
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