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General NPI Number Information
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NPI Number | 1467684621
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Entity Type | Individual
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Provider Name | SAMUEL ARTHUR MOORE MD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 501 20TH ST STE 503
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City | KNOXVILLE
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State | TN
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Zip | 37916-1809
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Country | US
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Telephone | 865-541-4321
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Fax | 865-541-4320
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Provider Business Mailing Address
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Address Line | 501 20TH ST STE 503
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City | KNOXVILLE
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State | TN
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Zip | 37916-1809
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Country | US
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Telephone | 865-541-4321
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Fax | 865-541-4320
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 51204
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | 51204
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License Number State | TN
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