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NPI Code Detail

MEDICARE: MR. ROSS JEROME NAGLER

MEDICARE:  MR. ROSS JEROME NAGLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor12554TN

General Provider Information

NPI Number : 1124960042
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROSS JEROME NAGLER
Provider Business Mailing Address
First Line : 316 LAUDERDALE AVE
Second Line :
City : COVINGTON
State : TN
Zip : 38019-2818
Country : US
Telephone Number : 901-949-9697
Fax Number :
Provider Business Practice Location Address
First Line : 134 TIMBER CREEK DR
Second Line :
City : CORDOVA
State : TN
Zip : 38018-4291
Country : US
Telephone Number : 901-554-5151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ MR. ROSS JEROME NAGLER ” Practice Location

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