Moak, Wilson E

Moak, Wilson E is an individual health care provider with primary practice located at 1190 N State St Ste 403, Jackson MS 39202-2413. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Moak, Wilson E can be contacted via phone (601) 353-2020.

Contact Information

Primary practice address
1190 N State St Ste 403 Jackson MS 39202-2413
Phone: (601) 353-2020
Fax: (601) 714-5110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 06305 Mississippi

Profile Details

NPI number 1184629818
LBN Legal business name Moak, Wilson E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184629818 NPPES
Mississippi MEDICAID 00013075

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