Moore, Jimmie G
Moore, Jimmie G is an individual health care provider with primary practice located at 3688 Veterans Memorial Dr Suite 200, Hattiesburg MS 39401-8246. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Moore, Jimmie G can be contacted via phone (601) 554-7400.Contact Information
Primary practice address
3688 Veterans Memorial Dr Suite 200
Hattiesburg MS 39401-8246
Phone: (601) 554-7400
Fax: (601) 554-7488
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA028 | Mississippi |
Profile Details
| NPI number | 1144255225 |
|---|---|
| LBN Legal business name | Moore, Jimmie G |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jan 12th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144255225 | NPPES |
| Mississippi | MEDICAID | 02274715 |
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