Provider Demographics
NPI:1164622692
Name:DR ROSE & WARD MD INC
Entity Type:Organization
Organization Name:DR ROSE & WARD MD INC
Other - Org Name:DR CATHERINE M ROSE MD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-299-9700
Mailing Address - Street 1:3017 WILMINGTON PIKE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4169
Mailing Address - Country:US
Mailing Address - Phone:937-299-9700
Mailing Address - Fax:937-299-9778
Practice Address - Street 1:3017 WILMINGTON PIKE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-4169
Practice Address - Country:US
Practice Address - Phone:937-299-9700
Practice Address - Fax:937-299-9778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9298331Medicare PIN