| Kelly G Ross Od Pa | |
|
1014 W Main St, Walnut Ridge, AR 72476-1004 | |
| (870) 886-2632 | |
| (870) 886-1514 |
| Full Name | Kelly G Ross Od Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1014 W Main St, Walnut Ridge, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982760955 | NPI | - | NPPES |
| 167096722 | Medicaid | AR | |
| 5F267 | Other | AR | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2485 (Arkansas) | Primary |
| Provider Name | Kelly G Ross |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073549200 PECOS PAC ID: 3870540271 Enrollment ID: I20050407000764 |
| Provider Name | Jonathan Ross |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881638328 PECOS PAC ID: 8022174903 Enrollment ID: I20090228000023 |
| Provider Name | Cody G Patterson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417330101 PECOS PAC ID: 1052629789 Enrollment ID: I20150930000887 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly G Ross Od Pa 1014 W Main St, P.o. Box 349, Walnut Ridge, AR 72476-1004 Ph: (870) 886-2632 | Kelly G Ross Od Pa 1014 W Main St, Walnut Ridge, AR 72476-1004 Ph: (870) 886-2632 |
Dr. Kelly G Ross, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1014 W Main St, Walnut Ridge, AR 72476 Phone: 870-886-2632 Fax: 870-886-1514 | |
Southern Eye Associates, Ltd Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1014 W Main St, Walnut Ridge, AR 72476 Phone: 870-886-2632 Fax: 870-886-1514 | |
John T Mchaney, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1014 W. Main St, Walnut Ridge, AR 72476 Phone: 870-886-2632 Fax: 870-886-1514 |