| Joseph S Moak Jr Md Pa | |
|
1040 Biglane Drive Brookhaven MS 39601 | |
| (601) 833-5051 | |
| (601) 835-0240 |
| Full Name | Joseph S Moak Jr Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1040 Biglane Drive, Brookhaven, Mississippi |
| Authorized Official Name and Position | Antha R. Restivo (OFFICE MANAGER) |
| Authorized Official Contact | 6018335051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph S Moak Jr Md Pa 1040 Biglane Drive Brookhaven MS 39601 Ph: (601) 833-5051 | Joseph S Moak Jr Md Pa 1040 Biglane Drive Brookhaven MS 39601 Ph: (601) 833-5051 |
| NPI Number | 1043639289 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 05/30/2014 |
| Medicare PECOS PAC ID | 4284850231 |
|---|---|
| Medicare Enrollment ID | O20140728001142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043639289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Joseph S Moak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184667800 PECOS PAC ID: 4486688496 Enrollment ID: I20050920000537 |
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