Individual
DR. MARY LINDA MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1030 RIVER OAKS DR, JACKSON, MS 39232-9553
(601) 936-0494
Mailing address
620 CROSSOVER RD, TUPELO, MS 38801-4944
(601) 936-0494
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13903
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05828281
—
MS
Enumeration date
07/31/2006
Last updated
09/29/2023
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