Kevin Emmanual Moore
Foot & Ankle Surgery
109 Osigian Blvd Ste 300
Warner Robins
, Georgia 31088-8924
Kevin Emmanual Moore
Foot & Ankle Surgery
109 Osigian Blvd Ste 300
Warner Robins
, Georgia 31088-8924
(478) 333-2173
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Kevin Emmanual Moore
- Po Box 6619
- Macon, GA
- Zip : 31208-6619
- Fax : (478) 333-2173
- Phone : (478) 333-2430
Second Address
- Kevin Emmanual Moore
- 109 Osigian Blvd Ste 300
- Warner Robins, GA
- Zip : 31088-8924
- Fax : (478) 333-2173
- Phone : (478) 333-2430
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213ES0103X | Foot & Ankle Surgery | 288 | OK |
| Y | 213ES0103X | Foot & Ankle Surgery | POD001181 | GA |
National Provider Identifier
| NPI | 1104111590 |
|---|---|
| Provider Name | Kevin Emmanual Moore |
| First Address | Macon, GA 31208-6619 |
| Second Address | Warner Robins, GA 31088-8924 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/06/2011 |
| Last Update Date | 01/02/2022 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 003116370B | (05) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.