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NPI Code Detail

MEDICARE: JOEL TUMALIUAN MOATS

MEDICARE: JOEL TUMALIUAN MOATS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPRN-NP204844GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN204844OTHERGAGEORGIA BOARD OF NURSING

General Provider Information

NPI Number : 1396477808
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL TUMALIUAN MOATS
Provider Business Mailing Address
First Line : 608 N KEVIN CT
Second Line :
City : STATESBORO
State : GA
Zip : 30461-2743
Country : US
Telephone Number : 912-690-0830
Fax Number :
Provider Business Practice Location Address
First Line : 100 S MADISON ST
Second Line :
City : THOMASVILLE
State : GA
Zip : 31792-5473
Country : US
Telephone Number : 229-236-0831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 12/12/2025

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Directions to “ JOEL TUMALIUAN MOATS ” Practice Location

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