Individual
JOEL ASHLEY MOORE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4209 LINCOLN RD, HATTIESBURG, MS 39402-3065
(601) 579-5400
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7283
(601) 579-5400
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24606
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06335874
—
MS
Enumeration date
06/15/2015
Last updated
08/30/2022
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