Individual
DR. KIRK ANTONIO MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5001 HARDY ST RM 1025, HATTIESBURG, MS 39402-1308
(601) 296-2090
(601) 296-2089
Mailing address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 296-2090
(601) 296-2089
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24973
MS
207R00000X
Internal Medicine Physician
Primary
25363
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03025358
—
MS
01
—
24973
MEDICAL LICENSE
MS
Enumeration date
08/08/2012
Last updated
06/15/2022
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