E.B. Ross, Jr MD-Stephen D Goodwin, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

E.B. ROSS, JR MD-STEPHEN D GOODWIN, MD

Practice address

120 Meadowcrest St
Suite 200
Gretna, LA 70056-5255

Phone

(504) 391-7650

Fax

(504) 394-7344

NPI assigned

Apr 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edwin B Ross Jr., M.D.

Title

President

Phone

(504) 391-7650

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1124246889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MEADOWCREST ST",
            "address_2": "SUITE 200",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565255",
            "telephone_number": "504-391-7650",
            "fax_number": "504-394-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEADOWCREST ST",
            "address_2": "SUITE 200",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565255",
            "telephone_number": "504-391-7650",
            "fax_number": "504-394-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E.B. ROSS, JR MD-STEPHEN D GOODWIN, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-391-7650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1146099",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1337994",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1379689",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giles James Duplechin II, BA PSYCHOLOGY
• Casey Lynn Duvall, MD
• Dina Marie Dyer, APRN
• Dyess Medical Center Incorporated
• James Malcolm Dyess, M.D.
• Shelita Edgerson
• Latasha D Edwards
• Charles Ekenta
• Ekhaya Youth Project
• Ekhaya Youth Project, Inc.

• Otolaryngology Physician in Gretna, LA
• Providers in Gretna, LA by specialty
• Otolaryngology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.