Healthcare Provider Details

I. General information

NPI: 1295780807
Provider Name (Legal Business Name): JULIA MOYE WORLY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: JULIEA MOYE

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 POST OAK TRITT RD STE 100
MARIETTA GA
30062
US

IV. Provider business mailing address

2155 POST OAK TRITT RD STE 100
MARIETTA GA
30062
US

V. Phone/Fax

Practice location:
  • Phone: 770-973-4700
  • Fax: 770-565-0326
Mailing address:
  • Phone: 770-973-4700
  • Fax: 770-565-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number051518
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: