NPI Code Detail JSON Logo

1316681216 NPI number — ELIZABETH WILSON MOORE MD

NPI Number: 1316681216
Health Care Provider/Practitioner: ELIZABETH WILSON MOORE MD

Information about “1316681216” NPI (ELIZABETH WILSON MOORE MD) exists in 1316681216 in HTML format HTML  |  1316681216 in plain Text format TXT  |  1316681216 in PDF (Portable Document Format) PDF  |  1316681216 in an XML format XML  formats.

NPI Number : 1316681216 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316681216",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MOORE",
    "FirstName": "ELIZABETH",
    "MiddleName": "WILSON",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MOORE",
    "OtherFirstName": "BETH",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "224 PARK AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FRANKFORT",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49635-9658",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "231-352-2990",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "224 PARK AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FRANKFORT",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49635-9658",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "231-352-2990",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/26/2022",
    "LastUpdateDate": "07/08/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "4351049317",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "4301514586",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.