Provider Demographics
NPI:1003037854
Name:MOY, RUBY (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBY
Middle Name:
Last Name:MOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 BARNES ROAD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-4845
Mailing Address - Country:US
Mailing Address - Phone:601-859-6582
Mailing Address - Fax:601-859-5171
Practice Address - Street 1:1600 BARNES ROAD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-4845
Practice Address - Country:US
Practice Address - Phone:601-859-6582
Practice Address - Fax:601-859-5171
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS07342207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine