Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 52433 | KY |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 047650 | GA |
NPI | 1245282037 |
---|---|
Provider Name | Dr. William Alexander Jackson Ross |
First Address | Atlanta, GA 30331-6326 |
Second Address | Glasgow, KY 42141-8068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00839462E | (05) | GA |
52433 | KY MEDICAL LICENSE (01) | KY |
H01817 | (02) | GA |