MEDICARE: NARICO CARNOD MOORE JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver	060354856	GA

General Provider Information

NPI Number	:	1053266882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARICO CARNOD MOORE JR.

Provider Business Mailing Address
First Line	:	184 BILES RD
Second Line	:
City	:	JACKSON
State	:	GA
Zip	:	30233-4616
Country	:	US
Telephone Number	:	943-284-6330
Fax Number	:

Provider Business Practice Location Address
First Line	:	184 BILES RD
Second Line	:
City	:	JACKSON
State	:	GA
Zip	:	30233-4616
Country	:	US
Telephone Number	:	943-284-6330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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Directions to “ NARICO CARNOD MOORE JR. ” Practice Location

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