Provider Demographics
NPI:1760455810
Name:ROSS, HUGH ALSWORTH (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:ALSWORTH
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1106
Mailing Address - Country:US
Mailing Address - Phone:607-547-3153
Mailing Address - Fax:607-547-6539
Practice Address - Street 1:ONE ATWELL ROAD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1106
Practice Address - Country:US
Practice Address - Phone:602-395-0718
Practice Address - Fax:602-277-8146
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34432207L00000X
NY262431207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ957590Medicaid
H91440Medicare UPIN
AZZ105526Medicare PIN