Provider Demographics
NPI:1558407353
Name:ROSS, JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2661
Mailing Address - Country:US
Mailing Address - Phone:423-954-9591
Mailing Address - Fax:423-954-3081
Practice Address - Street 1:7405 SHALLOWFORD RD
Practice Address - Street 2:SUITE 320
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2661
Practice Address - Country:US
Practice Address - Phone:423-954-9591
Practice Address - Fax:423-954-3081
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3052956OtherBLUECROSS BLUESHIELD
TN3674284Medicare ID - Type Unspecified
T74657Medicare UPIN