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Organization
MOORE PHYSICIAN SERVICES, LLC
Active
Organization
MOORE PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (PE SUPERVISOR)
(337) 609-1221
Entity
Organization
Contact information
Practice address
849 S THREE NOTCH ST, ANDALUSIA, AL 36420-5325
(334) 222-8466
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213027
—
AL
Enumeration date
01/29/2018
Last updated
03/23/2022
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