Individual
PAUL H MOORE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5306
(601) 984-6904
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5306
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
22004
MS
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
254426
NY
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
31773
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05182213
—
MS
Enumeration date
05/14/2008
Last updated
03/11/2015
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