Individual
DAVID MOORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 S GLOSTER ST, 4TH FLOOR EAST TOWER, TUPELO, MS 38801-4934
(662) 377-7150
(662) 377-7155
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
07340
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115011
—
MS
Enumeration date
04/07/2006
Last updated
07/08/2007
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