<Unavail>

LBN: O Fred Moore Iii Md Pc
<Unavail> is an health care organization with primary practice located at 503 Tickle Street , Dyersburg TN 38024. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. O Fred Moore Iii Md Pc can be contacted via phone (731) 285-5244, or through Moore, Olyn Fred via phone (731) 285-5244.

Contact Information

Primary practice address
503 Tickle Street Dyersburg TN 38024
Phone: (731) 285-5244
Fax: (731) 285-5244
Website:
Map and Directions
Authorized official contact:
Name: Moore, Olyn Fred Doctor of Medicine (MD)
Phone: (731) 285-5244

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X

Profile Details

NPI number 1720208242
LBN Legal business name O Fred Moore Iii Md Pc
DBA Doing business as <Unavail>
Authorized official Moore, Olyn Fred Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 26th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720208242 NPPES
Tennessee MEDICAID 3384206

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