Moore, Charles K.

Moore, Charles K. is an individual health care provider with primary practice located at 2500 North State Street Department Of Medicine/Division Of Cardiology, Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology. Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology is his primary health care specialty. Moore, Charles K. can be contacted via phone (601) 984-5630.

Contact Information

Primary practice address
2500 North State Street Department Of Medicine/Division Of Cardiology Jackson MS 39216-4500
Phone: (601) 984-5630
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 13284 Mississippi
Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology 207RA0001X 13284 Mississippi

Profile Details

NPI number 1699795641
LBN Legal business name Moore, Charles K.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jun 6th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699795641 NPPES
Mississippi Other RR 060036949 RAILROAD
Mississippi MEDICAID 00110493 RAILROAD
Mississippi Other P00618863 RAILROAD
Mississippi MEDICAID 1687821 RAILROAD

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