Individual
LEE ELLIS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 BAPTIST DR STE 220, MADISON, MS 39110-2031
(601) 985-9120
Mailing address
501 BAPTIST DR STE 220, MADISON, MS 39110-2031
(601) 985-9120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
209770
NC
207W00000X
Ophthalmology Physician
34523
OK
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
27439
MS
Other
Enumeration date
06/12/2015
Last updated
07/02/2020
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