Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35.137015 | OH |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 35137015 | OH |
NPI | 1295178614 |
---|---|
Provider Name | Phillip Randall Ross |
First Address | Cincinnati, OH 45219-2364 |
Second Address | West Chester, OH 45069-6542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 08/08/2019 |