Provider Demographics
NPI:1285657494
Name:MCDONALD, ROSS ALAN (SA-C)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:ALAN
Last Name:MCDONALD
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Gender:M
Credentials:SA-C
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Mailing Address - Street 1:PO BOX 21449
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-1449
Mailing Address - Country:US
Mailing Address - Phone:480-221-4815
Mailing Address - Fax:480-985-6247
Practice Address - Street 1:1524 E FAIRBROOK ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-5028
Practice Address - Country:US
Practice Address - Phone:480-221-4815
Practice Address - Fax:480-985-6247
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty