Individual
DR. JAMES STEPHEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
421 MARION AVE, MCCOMB, MS 39648-2709
(601) 249-0083
(601) 249-0309
Mailing address
421 MARION AVE, MCCOMB, MS 39648-2709
(601) 249-0083
(601) 249-0309
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
566
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01729377
—
MS
01
—
5627310001
MEDICARE DMEPOS SUPPLIER
MS
Enumeration date
05/04/2006
Last updated
03/07/2023
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