Individual
JOSEPH S MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S RAILROAD AVE, BROOKHAVEN, MS 39601-3331
(601) 835-0077
(601) 835-0095
Mailing address
201 S RAILROAD AVE, BROOKHAVEN, MS 39601-3331
(601) 835-0077
(601) 835-0095
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
10309
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124769
—
MS
Enumeration date
08/09/2006
Last updated
11/21/2007
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