DR. WALTER CARL MOSES III (NPI# 1770977134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770977134 |
| Entity Type | Individual |
| Full Name | DR. WALTER CARL MOSES III |
| Credential | DMD |
| Practice Address |
202 W Park Ave Greenwood MS 38930-3009 |
| Mailing Address |
622 County Road 190 Greenwood MS 38930-6980 |
| Practice Telephone | 6622190044 |
| Practice Fax Number | 6622190045 |
| Mailing Telephone | 6622990270 |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2019-10-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 3793-15 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07720764 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 840 N Oak Ave, Ruleville, MS 387713227 | 6627564000 |
| Street Address |
202 W PARK AVE |
| City | GREENWOOD |
| State | MS |
| Zip Code | 38930-3009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861480014 | Samuel H Lambdin | Specialist | 202 W Park Ave, Greenwood, MS 38930-3009 | 2005-10-12 |
| 1609407907 | Moses Oral and Facial Surgery LLC | Dentist | 202 W Park Ave, Greenwood, MS 38930-3009 | 2020-01-27 |
| 1528434214 | Kathryn Flanagan Evans | Nurse Practitioner | 202 W Park Ave, Greenwood, MS 38930-3009 | 2015-08-17 |
| 1679802946 | Greenwood Leflore Hospital | Internal Medicine | 202 W Park Ave, Greenwood, MS 38930 | 2009-12-16 |
| 1083868699 | S H Lambdin Md Pllc | Specialist | 202 W Park Ave, Greenwood, MS 38930-3009 | 2008-11-10 |
| 1689831844 | Richard Goldberg | Internal Medicine | 202 W Park Ave, Greenwood, MS 38930-3009 | 2008-05-16 |
| 1013905272 | Patricia Weathersby | Specialist | 202 W Park Ave, Greenwood, MS 38930-3009 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447871579 | Stewart Health Care Training Academy | Home Health Aide | 522 West Park Avenue Suite S, Greenwood, MS 38930 | 2020-04-29 |
| 1801386487 | Sunflower-humphreys Counties Progress, Inc. | Case Management | 414 Martin Luther King Dr, Indianola, MS 38930 | 2018-05-18 |
| 1053826610 | Sarah Malone | Counselor | 2504 Browing Road, Greenwood, MS 38930 | 2017-12-05 |
| 1780109850 | Jasmine Turner Edwards | Pharmacist | 2202 Us 82 W Frontage Rd, Greenwood, MS 38930 | 2017-08-09 |
| 1861916199 | Maurice Wright | Social Worker | 522 West Park Avenue, Suite Q-r, Greenwood, MS 38930 | 2017-07-28 |
| 1215464607 | Catherine Johnson | Counselor | 522 West Park Avenue, Greenwood, MS 38930 | 2017-05-16 |
| 1598205262 | Vignesh Kannan | Internal Medicine | Greenwood Leflore Hospital, 1401 River Rd, Greenwood, MS 38930 | 2017-03-01 |
| 1952847691 | Mischa Mccray | Counselor | 804 E Park Ave, Greenwood, MS 38930 | 2017-01-18 |
| 1760933147 | Ginger Caldero | Social Worker | 522 West Park Ave, Greenwood, MS 38930 | 2016-10-20 |
| 1942750617 | Greenwood Leflore Hospital | Psychiatry & Neurology | 1401 River Rd Rm 534, Greenwood, MS 38930 | 2016-10-06 |
| Find all providers in zip 38930 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497822662 | Scott Delano Whitaker | Oral & Maxillofacial Surgery | 2886 S Lamar Blvd, Oxford, MS 38655 | 2006-11-30 |
| 1831512359 | Premier Interventional Pain of Mississippi LLC | Oral & Maxillofacial Surgery | 1400 E Union St, Greenville, MS 38703-3246 | 2014-02-04 |
| 1033400197 | Premier Anesthesia of Mississippi LLC | Oral & Maxillofacial Surgery | 1400 E Union St, Greenville, MS 38703-3246 | 2011-04-25 |
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| 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.