BENJAMIN C MOORE


Address: 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206
Phone: 6012685640

BENJAMIN C MOORE (NPI# 1518131754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518131754
Entity Type Individual
Full Name BENJAMIN C MOORE
Other Name BEN C MOORE
Credential M.D.
Practice Address 421 S 28th Ave
Suite 200
Hattiesburg
MS 39401-7206
Mailing Address 415 S 28th Ave
Hattiesburg
MS 39401-7246
Practice Telephone 6012685640
Practice Fax Number 6012613507
Mailing Telephone 6012685640
Mailing Fax Number 6015795240
Enumeration Date 2008-04-18
Last Update Date 2020-07-21
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207V00000X Obstetrics & Gynecology 21901 MS Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MS UNITED HEALTHCARE 3493860 01
MS HEALTHSPRING 6060931 01
MS CIGNA 4738806 01
MS 04456312 05
MS AETNA 9496951 01

Other Providers BENJAMIN MOORE

NPI Name Taxonomy Address Enumeration
1447887096 Benjamin J Moore Physician Assistant 4920 S 30th St Ste 103, Omaha, NE 68107-1656 2020-03-24
1427562685 Benjamin Moore Physical Medicine & Rehabilitation 8301 E Prentice Ave Ste 207, Greenwood Village, CO 80111-2905 2017-11-27
1043668791 Benjamin Moore Physical Therapist 4909 Nolensville Rd, Nashville, TN 37211-5411 2016-06-02
1609241819 Benjamin Moore Massage Therapist 2207 N Molter Rd Ste 250, Liberty Lake, WA 99019-7582 2015-12-14
1992186415 Benjamin Ross Moore Dentist 15 Rawls Rd, Suite 200, Angier, NC 27501-6033 2015-06-10
1568801504 Benjamin Moore Counselor 2305 Old County Rd, Pocahontas, AR 72455-4148 2013-06-24
1710208848 Benjamin Virlow Moore Social Worker 575 East 100 South, Price, UT 84501 2010-06-11
1548459498 Benjamin Alan Moore Optometrist 401 W Main St, Suite A, John Day, OR 97845-1075 2007-10-16
1033240981 Benjamin R Moore Physical Therapist 555 East Broadway, Suite 100, Jackson, WY 83001 2007-03-09
1558342196 Benjamin E Moore Specialist 2 Shircliff Way, Ste 925, Jacksonville, FL 32204-4753 2005-11-10

Office Location

Street Address 421 S 28TH AVE
SUITE 200
City HATTIESBURG
State MS
Zip Code 39401-7206

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073539409 Laura N Keith Nurse Practitioner 421 S 28th Ave, Hattiesburg, MS 39401-7236 2006-07-15
1811302995 Hattiesburg Clinic, Pa Obstetrics & Gynecology 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 2014-06-26
1922435130 Marlena Marie Bradley Nurse Practitioner 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 2013-10-02
1659635027 Amanda Dawn Sellers Obstetrics & Gynecology 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 2012-06-29
1265744437 Lauren Ayres Bethea Obstetrics & Gynecology 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 2010-07-05
1891970521 Marie M Darby Obstetrics & Gynecology 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 2007-12-31
1447431465 Jennifer Cain Bailey Obstetrics & Gynecology 421 S 28th Ave, Hattiesburg, MS 39401-7206 2007-11-19
1518175314 Hattiesburg Clinic, P.a. Pathology 421 S 28th Ave, Hattiesburg, MS 39401-7206 2007-05-18
1336351659 Leigh Anne Strong Pathology 421 S 28th Ave, Hattiesburg, MS 39401-7236 2007-05-07
1982785820 Hattiesburg Clinic Pa Obstetrics & Gynecology 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 2006-10-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598315863 Lisa Thornton Technician 18 Timberline Dr., Hattiesburg, MS 39401 2019-09-18
1548813637 Caroline Estes Barnes Counselor Barnes, 8 App Slade Road, Hattiesburg, MS 39401 2019-07-18
1396252441 Selection Healthcare Services, LLC In Home Supportive Care 606 Adeline St Ste 1c, Hattiesburg, MS 39401 2018-01-10
1225545585 Whitney Wilkinson Nurse Practitioner 301 South 28th Avenue, Hattiesburg, MS 39401 2018-01-08
1740795806 Forrest General Hospital Pharmacy 1414 South 28th Avenue, Hattiesburg, MS 39401 2017-12-11
1275058455 Casey Payne Pharmacist 6130 Us 49, Hattiesburg, MS 39401 2017-08-08
1225562705 Sarah Marie Hudson Family Medicine 6051 Us Highway 49 S, Hattiesburg, MS 39401 2017-04-12
1043671704 The Covington's Cove Assisted Living Center LLC Assisted Living Facility 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 2016-03-09
1780083626 Dominique Reed Watson Pharmacist 602 Adeline St, Hattiesburg, MS 39401 2014-08-15
1558778936 Willie Davis Jr. Day Training, Developmentally Disabled Services 701 Duke Ave., Hattiesbiurg, MS 39401 2014-07-17
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Taxonomy Information

Taxonomy Code 207V00000X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology

Taxonomy Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871732032 Marcus Leon Hogan Obstetrics & Gynecology 6111 U S Highway 49, Hattiesburg, MS 39401-7170 2009-02-11
1922184274 Womens Pavilion of South Mississippi Pllc Obstetrics & Gynecology 5003 Hardy St Ste 350, Hattiesburg, MS 39402-1323 2006-10-30
1972576460 Marion Catherine Sessums Obstetrics & Gynecology 6524 U S Highway 98, Hattiesburg, MS 39402-8569 2006-02-07
1821093691 John Michael Woods Obstetrics & Gynecology 62 Old Airport Rd, Hattiesburg, MS 39401 2005-06-16
1760882815 Womens Pavilion of South Mississippi Pllc Obstetrics & Gynecology 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1319 2014-08-26
1629403480 Forrest County General Hospital Obstetrics & Gynecology 1 Lincoln Pkwy, Suite 103, Hattiesburg, MS 39402-3262 2013-09-11
1629418074 Shantele Hinton Bolton Obstetrics & Gynecology 6524 U S Highway 98, Hattiesburg, MS 39402-8569 2013-06-30
1659635027 Amanda Dawn Sellers Obstetrics & Gynecology 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 2012-06-29
1265744437 Lauren Ayres Bethea Obstetrics & Gynecology 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 2010-07-05
1497918825 Andrea Mcdaniel Carter Obstetrics & Gynecology 6524 U S Highway 98, Hattiesburg, MS 39402-8569 2008-07-07
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City HATTIESBURG
Zip Code 39401

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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