Individual
MRS. CHARLOTTE BAKER MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 MARSHALL ST STE G07, JACKSON, MS 39202-1651
(601) 968-3238
(601) 968-3237
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA00329
MS
363AS0400X
Surgical Physician Assistant
Primary
PA00329
MS
Other
Enumeration date
10/26/2016
Last updated
08/27/2019
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