Moore, Simone Shardae Williams

Moore, Simone Shardae Williams is an individual health care provider with primary practice located at 702 Martin Luther King St , Mound Bayou MS 38762-9314. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Moore, Simone Shardae Williams can be contacted via phone (662) 741-8800.

Contact Information

Primary practice address
702 Martin Luther King St Mound Bayou MS 38762-9314
Phone: (662) 741-8800
Fax: (662) 741-2700
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 27978 Mississippi
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1730602806
LBN Legal business name Moore, Simone Shardae Williams
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2017
Last updated Aug 5th, 2020 - about 5 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 1730602806 NPPES
Mississippi MEDICAID 04501349

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