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NPI Code Detail

MEDICARE: JOSEPH ANDREW MOORE M.D.

MEDICARE: JOSEPH ANDREW MOORE M.D.
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
1207R00000XInternal Medicine PhysicianME170241FL
2207RG0100XGastroenterology Physician76496TN

General Provider Information

NPI Number : 1639794258
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH ANDREW MOORE M.D.
Provider Business Mailing Address
First Line : 4976 ALPHA LN
Second Line :
City : HIXSON
State : TN
Zip : 37343-5470
Country : US
Telephone Number : 423-497-5355
Fax Number :
Provider Business Practice Location Address
First Line : 1324 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-4543
Country : US
Telephone Number : 863-687-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2020
Last Update Date : 04/14/2026

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Directions to “ JOSEPH ANDREW MOORE M.D.” Practice Location

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