Individual
LONNIE L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1022 MARTIN LUTHER KING DR, MARKS, MS 38646-1832
(662) 326-3500
(901) 756-5564
Mailing address
1022 MARTIN LUTHER KING DR, MARKS, MS 38646-1832
(166) 232-6350
(662) 326-3502
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901567
MS
Other
Enumeration date
06/21/2016
Last updated
08/02/2016
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