| Thomas C Moore, MD | |
|
1115 N Frontage Rd, Vicksburg, MS 39180-5102 | |
| (601) 634-8790 | |
| Not Available |
| Full Name | Thomas C Moore |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1115 N Frontage Rd, Vicksburg, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184655060 | NPI | - | NPPES |
| 00115748 | Medicaid | MS | |
| 5699557 | Other | MS | AETNA |
| 1693804 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 14614 (Mississippi) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas C Moore, MD 1115 N Frontage Rd, Vicksburg, MS 39180-5102 Ph: (601) 634-8790 | Thomas C Moore, MD 1115 N Frontage Rd, Vicksburg, MS 39180-5102 Ph: (601) 634-8790 |
Lisa D Fairchild, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000 |
Dr. Izzeddin Kamelmaz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-6001 |
Constance Phylea Barnes-woods, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-3391 Fax: 601-883-3318 |
Elizabeth N Roy, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000 |
Danielle Sheryl-lee Nelson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Us-61 N, Vicksburg, MS 39183 Phone: 601-883-5000 |
Geri L Weiland, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000 |
Gordon W Sluis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1115 N Frontage Rd, Vicksburg, MS 39180 Phone: 601-634-8790 |