| John Moore, | |
|
415 S 28th Ave, Hattiesburg, MS 39401-7246 | |
| (601) 268-5888 | |
| (601) 261-3587 |
| Full Name | John Moore |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 12 Years |
| Location | 415 S 28th Ave, Hattiesburg, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063824688 | NPI | - | NPPES |
| 04421823 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | ME124782 (Florida) | Secondary |
| 208800000X | Urology | 19690 (Florida) | Secondary |
| 208800000X | Urology | 26534 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Encompass Health-home Health & Hospice | Hattiesburg, MS | Home health agency |
| Forrest General Hospital | Hattiesburg, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hattiesburg Clinic Pa | 5193706794 | 492 |
| Entity Name | Hattiesburg Clinic Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740213446 PECOS PAC ID: 5193706794 Enrollment ID: O20040528000685 |
| Mailing Address | Practice Location Address |
|---|---|
| John Moore, 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 268-5888 | John Moore, 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 268-5888 |
Dr. Hal T Liddell, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 139 Fairfield Dr, Hattiesburg, MS 39402 Phone: 601-450-2401 Fax: 601-450-2433 | |
Sean Philip Douglas, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-579-5240 | |
Dr. Nathan P Shappley, M.D. Urology Medicare: Medicare Enrolled Practice Location: 101 Aldersgate Cir, Hattiesburg, MS 39402 Phone: 601-261-5800 Fax: 601-261-5813 | |
Bradley N Secrest, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-261-3587 | |
Woodie J Wilson Jr., MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-261-3587 | |
David C Stout, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 4 Pebble Crk, Hattiesburg, MS 39402 Phone: 601-261-9323 |