Individual
BRANDEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
611 ALCORN DR, CORINTH, MS 38834-9321
(662) 293-7686
Mailing address
121 JUMPER LN, CORINTH, MS 38834-6033
(765) 532-6288
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-3170
MS
207RP1001X
Pulmonary Disease Physician
Primary
02006822A
IN
Other
Enumeration date
07/01/2016
Last updated
08/05/2022
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