Moore, John

Moore, John is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Moore, John can be contacted via phone (601) 268-5888.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 268-5888
Fax: (601) 261-3587
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X ME124782 Florida
Allopathic & Osteopathic Physicians / Urology 208800000X 19690 Florida
Allopathic & Osteopathic Physicians / Urology 208800000X 26534 Mississippi

Profile Details

NPI number 1063824688
LBN Legal business name Moore, John
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2014
Last updated Jul 8th, 2020 - about 5 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 1063824688 NPPES
Mississippi MEDICAID 04421823

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