Individual
CHRISTOPHER GUNNAR MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
764 LAKELAND DR, JACKSON, MS 39216-4651
(601) 984-6800
Mailing address
1012 COBBLESTONE PL, BRANDON, MS 39042-2050
(479) 414-4405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-5034
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2023
Last updated
07/20/2023
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