Individual
MATTHEW C MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 MARSHALL ST STE 301, JACKSON, MS 39202-1687
(601) 353-9900
(601) 353-3654
Mailing address
501 MARSHALL ST STE 301, JACKSON, MS 39202-1687
(013) 539-9006
(601) 353-3654
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
29978
MS
208800000X
Urology Physician
39978
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06152598
—
MS
Enumeration date
03/23/2017
Last updated
08/29/2022
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