Provider Demographics
NPI:1285638627
Name:ROSS, TAMI RA (OD)
Entity type:Individual
Prefix:DR
First Name:TAMI
Middle Name:RA
Last Name:ROSS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:211 N ROBINSON AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-7109
Mailing Address - Country:US
Mailing Address - Phone:405-232-0877
Mailing Address - Fax:405-232-5956
Practice Address - Street 1:211 N ROBINSON AVE
Practice Address - Street 2:STE 130
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-7101
Practice Address - Country:US
Practice Address - Phone:405-232-0877
Practice Address - Fax:405-232-5956
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2008-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2025152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1114139680OtherGROUP NPI
OKU04490Medicare UPIN
OK1017340001Medicare NSC