CHARLES ROBERT MOORE

HATTIESBURG, MS
NPI1801058821
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: MS  20677)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL  TRN#12298)
Enumeration Date2008-06-30
Last Update Date2011-10-24
Business Address
-- CHARLES ROBERT MOORE MD
139 FAIRFIELD DR
HATTIESBURG, MS 39402-1303
Phone number: 601-450-2417
Mailing Address
-- CHARLES ROBERT MOORE MD
139 FAIRFIELD DR
HATTIESBURG, MS 39402-1303
Phone number: 601-450-2417