Ross, Blaine M
Ross, Blaine M is an individual health care provider with primary practice located at 2735 Silver Creek Road , Bullhead City AZ 86442. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Ross, Blaine M can be contacted via phone (928) 763-2273.Contact Information
Primary practice address
2735 Silver Creek Road
Bullhead City AZ 86442
Phone: (928) 763-2273
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 32191 | Arizona |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 32191 | Arizona |
Profile Details
| NPI number | 1629018197 |
|---|---|
| LBN Legal business name | Ross, Blaine M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Oct 31st, 2007 - about 17 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 | 1629018197 | NPPES |
| Arizona | Other | 986789 | AHCCCS |
| Arizona | Other | AZ0156280 | AHCCCS |
| Arizona | Other | P00376172 | AHCCCS |
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