Individual
JUSTIN BOONE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF EMERGENCY MEDICINE, JACKSON, MS 39216-4500
(601) 984-5570
Mailing address
2500 N STATE ST, DEPARTMENT OF EMERGENCY MEDICINE, JACKSON, MS 39216-4500
(601) 984-5570
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-2340
MS
Other
Enumeration date
04/14/2009
Last updated
07/05/2010
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