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Charles Robert Moore, MD
Urology Physician in Hattiesburg, Mississippi
NPI 1801058821

Charles Robert Moore is a Urology Physician based in Hattiesburg, MS. Charles Robert Moore practices in Hattiesburg, MS and has the professional credentials of MD. The NPI Number for Charles Robert Moore is 1801058821 and holds a License No. TRN#12298 (Mississippi).

The current practice location address for Charles Robert Moore is 139 Fairfield Dr, Hattiesburg, MS and can be reached out via phone at 601-450-2417 and via fax at 601-450-2434.

Location: 139 Fairfield Dr, Hattiesburg, MS, 39402-1303
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1801058821
Provider Name
Charles Robert Moore
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
139 Fairfield Dr, Hattiesburg, MS, 39402-1303
Phone Number
601-450-2417
Fax Number
601-450-2434
Provider Enumeration Date
06/30/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
05137554 05 MS
institution
Provider Business Practice Location Address Details
Address
139 Fairfield Dr
City
Hattiesburg
State
Mississippi
Zip
39402-1303
Phone Number
601-450-2417
Fax Number
601-450-2434
person
Provider Business Mailing Address Details
Address
139 Fairfield Dr
City
Hattiesburg
State
Mississippi
Zip
39402-1303
Phone Number
601-450-2417
Fax Number
601-450-2434
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
208800000X
License No.
20677 (Mississippi)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
TRN#12298 (Florida)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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