Individual
MR. ROBERT KEITH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1465 LAKELAND DR, JACKSON, MS 39216-4719
(769) 777-1058
(769) 230-2864
Mailing address
550 POST RD, 709, RIDGELAND, MS 39157-9601
(601) 513-1108
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R882271
MS
Other
Enumeration date
07/17/2012
Last updated
01/26/2016
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