Moore, Thomas C

Moore, Thomas C is an individual health care provider with primary practice located at 1115 N Frontage Rd , Vicksburg MS 39180-5102. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Moore, Thomas C can be contacted via phone (601) 634-8790.

Contact Information

Primary practice address
1115 N Frontage Rd Vicksburg MS 39180-5102
Phone: (601) 634-8790
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 14614 Mississippi

Profile Details

NPI number 1184655060
LBN Legal business name Moore, Thomas C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Aug 5th, 2008 - 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 1184655060 NPPES
Mississippi MEDICAID 00115748
Mississippi Other 5699557
Mississippi MEDICAID 1693804

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