Gross, Jody R
Gross, Jody R is an individual health care provider with primary practice located at 1000 N Oak Ave , Marshfield WI 54449-5777. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is her primary health care specialty. Gross, Jody R can be contacted via phone (715) 387-5065.Contact Information
Primary practice address
1000 N Oak Ave
Marshfield WI 54449-5777
Phone: (715) 387-5065
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 26376 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 26376 | Wisconsin |
Profile Details
| NPI number | 1114028941 |
|---|---|
| LBN Legal business name | Gross, Jody R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Sep 30th, 2010 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114028941 | NPPES |
| Wisconsin | MEDICAID | 30590900 |
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