Individual provider · Type 1 NPI

Walter Thomas Moore, MD

Student in an Organized Health Care Education/Training Program · Jackson, MS

NPI number 1396569844 Active

Practice location

1225 N State St
Jackson, MS 39202-2064

Call (601) 968-1000 Map

Mailing address

1190 N State St Ste 400
Jackson, MS 39202-2413

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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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About NPI 1396569844

Walter Thomas Moore, MD's National Provider Identifier is 1396569844, issued on Nov 12, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jackson, MS. The record was last updated on Mar 30, 2026.