Provider Demographics
NPI:1376516690
Name:ROSS, DAVID K (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1657
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66601-1657
Mailing Address - Country:US
Mailing Address - Phone:785-295-5307
Mailing Address - Fax:785-231-5991
Practice Address - Street 1:4646 NW FIELDING RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66618-2588
Practice Address - Country:US
Practice Address - Phone:785-286-4475
Practice Address - Fax:785-286-4423
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0416213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100085250JMedicaid
KS100085250JMedicaid
KSKA2037079Medicare PIN