Ross, Mark D

Ross, Mark D is an sole proprietor health care provider with primary practice located at 330 Franklin Rd , Scottsville KY 42164-8805. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ross, Mark D can be contacted via phone (270) 237-3871.

Contact Information

Primary practice address
330 Franklin Rd Scottsville KY 42164-8805
Fax: (270) 237-5057
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1244DT Kentucky

Profile Details

NPI number 1174623292
LBN Legal business name Ross, Mark D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Jul 4th, 2008 - about 18 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 1174623292 NPPES
Kentucky Other 0000053704 BCBS
Kentucky MEDICAID 77012441 BCBS

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