Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | TN |
NPI | 1720013089 |
---|---|
Provider Name | Dr. Jeffrey Karl Moore SR. |
First Address | Nashville, TN 37203-2846 |
Second Address | Nashville, TN 37203-2846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 26/07/2007 |