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NPI Code Detail

MEDICARE: LESLIE JARROTT MOORE MD

MEDICARE: LESLIE JARROTT MOORE MD
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
1208600000XSurgery Physician32261SC
2208C00000XColon & Rectal Surgery Physician32261SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00944488OTHERSCMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437113651
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE JARROTT MOORE MD
Provider Business Mailing Address
First Line : PO BOX 743904
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3904
Country : US
Telephone Number : 803-296-7320
Fax Number : 803-296-7330
Provider Business Practice Location Address
First Line : 1333 TAYLOR ST STE 5F
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2951
Country : US
Telephone Number : 803-748-9966
Fax Number : 803-748-7174
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 09/26/2018

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Directions to “ LESLIE JARROTT MOORE MD” Practice Location

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