John Moore, | |
415 S 28th Ave, Hattiesburg, MS 39401-7246 | |
(601) 268-5888 | |
(601) 261-3587 |
Full Name | John Moore |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 10 Years |
Location | 415 S 28th Ave, Hattiesburg, Mississippi |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063824688 | NPI | - | NPPES |
04421823 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | ME124782 (Florida) | Secondary |
208800000X | Urology | 19690 (Florida) | Secondary |
208800000X | Urology | 26534 (Mississippi) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Forrest General Hospital | Hattiesburg, MS | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Hattiesburg Clinic, Pa | 5193706794 | 488 |
Entity Name | Hattiesburg Clinic Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740213446 PECOS PAC ID: 5193706794 Enrollment ID: O20040528000685 |
Mailing Address | Practice Location Address |
---|---|
John Moore, 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 268-5888 | John Moore, 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 268-5888 |
Dr. Hal T Liddell, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 139 Fairfield Dr, Hattiesburg, MS 39402 Phone: 601-450-2401 Fax: 601-450-2433 | |
Sean Philip Douglas, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-579-5240 | |
Dr. Nathan P Shappley, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 101 Aldersgate Cir, Hattiesburg, MS 39402 Phone: 601-261-5800 Fax: 601-261-5813 | |
Bradley N Secrest, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-261-3587 | |
Woodie J Wilson Jr., MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-261-3587 | |
David C Stout, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 4 Pebble Crk, Hattiesburg, MS 39402 Phone: 601-261-9323 |