Individual
DONALD G MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
Mailing address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
16668
MS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
16668
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122052
—
MS
Enumeration date
10/17/2006
Last updated
02/09/2017
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