Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | C-2586 | AR |
NPI | 1003906520 |
---|---|
Provider Name | Dr. Ashley Sloan Ross |
First Address | Little Rock, AR 72207-1917 |
Second Address | Little Rock, AR 72205-5484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DO4887 | (02) | AR |