Seketa S Ross
Individual provider Active NPI Contractor · Magnolia, AR
NPI 1497878359 · NPPES record last updated Jul 25, 2007
Key facts
- NPI
- 1497878359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 904 W Main St
Magnolia, AR 71753-3318 - Phone
- (870) 901-6150
- Fax
- (870) 234-8663
- NPI assigned
- Apr 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | AR | Yes |
Addresses
Primary practice location
904 W Main St
Magnolia, AR 71753-3318
Mailing address
904 W Main St
Magnolia, AR 71753-3318
Phone (870) 901-6150
Other providers in Magnolia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.