Rose, Kenneth D

Rose, Kenneth D is an individual health care provider with primary practice located at 603 Medical Parkway , Enterprise OR 97828. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Rose, Kenneth D can be contacted via phone (541) 426-3870.

Contact Information

Primary practice address
603 Medical Parkway Enterprise OR 97828
Phone: (541) 426-3870
Fax: (541) 426-1901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 01055738 Indiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 28952 Oregon

Profile Details

NPI number 1588658801
LBN Legal business name Rose, Kenneth D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2005
Last updated Dec 4th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588658801 NPPES
Indiana MEDICAID 200355260

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