| Diane E Ross Md Pa | |
|
2160 E Pass Road Suite D Gulfport MS 39507-3801 | |
| (228) 896-3317 | |
| (228) 896-3314 |
| Full Name | Diane E Ross Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2160 E Pass Road, Gulfport, Mississippi |
| Authorized Official Name and Position | Diane E Ross (PRESIDENT) |
| Authorized Official Contact | 2288963317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane E Ross Md Pa 2160 E Pass Road Suite D Gulfport MS 39507-3801 Ph: (228) 896-3317 | Diane E Ross Md Pa 2160 E Pass Road Suite D Gulfport MS 39507-3801 Ph: (228) 896-3317 |
| NPI Number | 1033381348 |
|---|---|
| Provider Enumeration Date | 03/26/2008 |
| Last Update Date | 08/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033381348 | NPI | - | NPPES |
| 01121509 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 09562 (Mississippi) | Primary |
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