| Doctor Name: | DR. CARL WENDELL ROSS |
| NPI Number: | 1295788370 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 04474R |
| Business Practice Address: | 410 Louisiana Ave Lake Charles, LA - 706013230 |
| Business Phone Number: | 3374394923 |
| Business Fax Number: | 3374394410 |
| Mailing Address: | 1803 Enterprise Blvd, LAKE CHARLES |
| State: | LA |
| Postal Code: | 706016369 |
| Phone Number: | 3374363881 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 04474R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |