Individual
DR. JOSEPH SAMUEL MOAK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIV GENERAL INTERNAL MEDICINE, JACKSON, MS 39216-4500
(601) 984-5660
Mailing address
P.O. BOX 24146, UNIVERSITY PHYSICIANS, PLLC, JACKSON, MS 39225-4146
(601) 815-5047
(601) 815-9596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
08390
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08775083
—
MS
Enumeration date
06/13/2006
Last updated
03/05/2008
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