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NPI Code Detail

MEDICARE: JAMES D MOORE MD

MEDICARE:   JAMES D MOORE  MD
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
1207Q00000XFamily Medicine PhysicianME62327FL

General Provider Information

NPI Number : 1750353579
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES D MOORE MD
Provider Business Mailing Address
First Line : PO BOX 45443
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84145-0443
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 400 COLONNADE DR STE 160
Second Line :
City : PONTE VEDRA
State : FL
Zip : 32081-6236
Country : US
Telephone Number : 904-248-1020
Fax Number : 904-824-5333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 02/19/2021

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Directions to “ JAMES D MOORE MD” Practice Location

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