Individual
MRS. STACIE L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
223 W MAIN ST, WEST POINT, MS 39773
(662) 494-2020
(662) 492-0045
Mailing address
PO BOX 1137, 223 W MAIN ST, WEST POINT, MS 39773
(662) 494-2020
(662) 492-0045
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
657
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880170
—
MS
Enumeration date
08/29/2006
Last updated
11/15/2010
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