Individual
DAVID LAWRENCE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1071 E FRANKLIN ST, CARTHAGE, MS 39051-3601
(601) 267-4562
(601) 267-4589
Mailing address
PO BOX 435, CARTHAGE, MS 39051-0435
(601) 267-3625
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08774
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017434
—
MS
Enumeration date
08/29/2006
Last updated
12/03/2018
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