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Organization

VICKSBURG HMA PHYSICIAN MGMT

Active
Other names
Medical Associates of Vicksburg
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN H MOORE (PRACTICE ADMINISTRATOR)
(601) 262-1000
Entity
Organization

Contact information

Practice address
2080 S FRONTAGE RD, STE 100, VICKSBURG, MS 39180-5328
(601) 262-1000
(601) 262-1211
Mailing address
2080 S FRONTAGE RD, STE 100, VICKSBURG, MS 39180-5328
(601) 262-1000
(601) 262-1211

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R871321
MS

Other

Enumeration date
08/14/2013
Last updated
08/14/2013
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