Provider Demographics
NPI:1366532541
Name:KLINGSBERG, ROSS CARL (MD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:CARL
Last Name:KLINGSBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:BOX 8509
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-6966
Mailing Address - Fax:504-988-8629
Practice Address - Street 1:1430 TULANE AVE
Practice Address - Street 2:BOX 8509
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-8600
Practice Address - Fax:504-988-8629
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2016-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.15235R207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01807742Medicaid
LA1061379Medicaid
LA1061379Medicaid