Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Robert Moore, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1801058821

Charles Robert Moore, MD is an Urology in Hattiesburg, Mississippi. Graduated from Louisiana State University School of Medicine in New Orleans in 2003, 23 years ago. Practices with Southern Urology, P. A., a 4-clinician group and accepts Medicare assignment. Licensed in Florida and Mississippi.

Years since qualifying
23
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
FL, MS
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

139 Fairfield Dr
Hattiesburg, MS 39402-1303
Phone: (601) 450-2417
Fax: (601) 450-2434
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 20677 (MS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence TRN#12298 (FL)

Record details

NPI number1801058821
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 30, 2008
Last updated in NPPESOctober 24, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2003 (23 years in practice)
Group practice Southern Urology, P. A. — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Hattiesburg