Provider Demographics
NPI:1942439542
Name:ROSE, REBECCA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANNE
Last Name:ROSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1756 POPPS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2118
Mailing Address - Country:US
Mailing Address - Phone:228-865-3200
Mailing Address - Fax:228-575-1660
Practice Address - Street 1:1756 POPPS FERRY RD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2118
Practice Address - Country:US
Practice Address - Phone:228-865-3200
Practice Address - Fax:228-575-1660
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2020-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MST-2238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine