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General NPI Number Information
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NPI Number | 1174720981
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Entity Type | Organization
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Legal Business Name | MOORE FAMILY MEDICAL PLC
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 115 N THOMPSON LN
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City | MURFREESBORO
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State | TN
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Zip | 37129-4305
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Country | US
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Telephone | 615-896-4482
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Fax | 615-896-4472
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Provider Business Mailing Address
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Address Line | 115 N THOMPSON LN
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City | MURFREESBORO
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State | TN
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Zip | 37129-4305
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Country | US
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Telephone | 615-896-4482
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Fax | 615-896-4472
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Authorized Official
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Title or Position | MEMBER
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Name | TIMOTHY MOORE
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Credential |
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Telephone | 615-896-4482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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