| Lonnie L Moore, NP | |
|
1022 Martin Luther King Dr, Marks, MS 38646-1832 | |
| (662) 326-3500 | |
| (901) 756-5564 |
| Full Name | Lonnie L Moore |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 1022 Martin Luther King Dr, Marks, 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 |
|---|---|---|---|
| 1962852988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 901567 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sunflower Home Health | Cleveland, MS | Home health agency |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Delta Medical Foundation | 2163777046 | 9 |
| Entity Name | Delta Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508363060 PECOS PAC ID: 2163777046 Enrollment ID: O20180618001135 |
| Entity Name | Ridgeland Medical Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053917849 PECOS PAC ID: 9032524400 Enrollment ID: O20210217000175 |
| Mailing Address | Practice Location Address |
|---|---|
| Lonnie L Moore, NP 1022 Martin Luther King Dr, Marks, MS 38646-1832 Ph: (166) 232-6350 | Lonnie L Moore, NP 1022 Martin Luther King Dr, Marks, MS 38646-1832 Ph: (662) 326-3500 |
Seng P Pang, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 340 Getwell St, Marks, MS 38646 Phone: 662-902-7531 | |
Mr. George Edward Farrell, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 411 Poplar Street, Marks, MS 38646 Phone: 662-326-9232 Fax: 662-326-8851 | |
Ms. Lea Ann Byrd, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1024 Martin Luther King Dr, Marks, MS 38646 Phone: 662-326-3500 | |
Mrs. Patsy Ann Thompson, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 350 Getwell St, Marks, MS 38646 Phone: 662-326-8031 Fax: 662-326-8560 |