| Jeremy Ross Md Pllc | |
|
333 S 38th St Ste A Muskogee OK 74401-4937 | |
| (918) 682-8631 | |
| Not Available |
| Full Name | Jeremy Ross Md Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 333 S 38th St Ste A, Muskogee, Oklahoma |
| Authorized Official Name and Position | Jeremy Michael Ross (OWNER) |
| Authorized Official Contact | 9186828631 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy Ross Md Pllc 333 S 38th St Ste A Muskogee OK 74401-4937 Ph: (918) 682-8631 | Jeremy Ross Md Pllc 333 S 38th St Ste A Muskogee OK 74401-4937 Ph: (918) 682-8631 |
| NPI Number | 1053814160 |
|---|---|
| Provider Enumeration Date | 03/14/2018 |
| Last Update Date | 03/14/2018 |
| Medicare PECOS PAC ID | 7012263833 |
|---|---|
| Medicare Enrollment ID | O20180710002011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053814160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 31424 (Oklahoma) | Primary |
| Provider Name | Jeremy Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063890697 PECOS PAC ID: 9032410071 Enrollment ID: I20180723001327 |
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