Individual
JOE R. ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1421 N STATE ST, SUITE 403, JACKSON, MS 39202-1658
(601) 353-9900
(601) 353-3654
Mailing address
1421 N STATE ST, SUITE 403, JACKSON, MS 39202-1658
(601) 353-9900
(601) 353-3654
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
06768
MS
208800000X
Urology Physician
53526E3603
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115691
—
MS
01
—
340012772
MEDICARE RR
—
Enumeration date
07/07/2006
Last updated
04/27/2010
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