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General NPI Number Information
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NPI Number | 1396039988
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Entity Type | Organization
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Legal Business Name | MOORE'S MEDICAL MANAGEMENT
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 02/26/2023
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Provider Practice Location Address
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Address Line | 2333 MURDOCK RD
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City | MARIETTA
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State | GA
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Zip | 30062-4572
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Country | US
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Telephone | 404-472-7345
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Fax |
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Provider Business Mailing Address
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Address Line | 2333 MURDOCK RD
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City | MARIETTA
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State | GA
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Zip | 30062-4572
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Country | US
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Telephone | 404-472-7345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | XAVIER C MOORE
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Credential | M.D.
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Telephone | 678-382-8091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 055619
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License Number State | GA
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