Individual
MR. NATHAN TYLER ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHPP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2005
(601) 496-9452
Mailing address
504 CLINTON CENTER DR STE 4300, CLINTON, MS 39056-5610
(601) 815-2005
(601) 815-0434
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
621124
MS
Other
Enumeration date
02/28/2014
Last updated
07/16/2025
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