Millard I. Ross, M.D., LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

15315 Issued in GA

Legal business name

MILLARD I. ROSS, M.D., LLC

Practice address

1412 Milstead Ave NE
Conyers, GA 30012-3877

Phone

(678) 413-7738

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Millard I Ross Jr., M.D.

Title

Chairman

Phone

(770) 713-2456

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1538339338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 HIGHWAY 212 SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943370",
            "telephone_number": "770-213-2456",
            "fax_number": "770-388-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "678-413-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLARD I. ROSS, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MILLARD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "770-713-2456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "15315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000148552B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.