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Organization
FALLEN LEAF MEDICAL
Active
Organization
FALLEN LEAF MEDICAL
Active
Other names
Fallen Leaf Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL RADFORD MOORE MD (OWNER)
(865) 549-0750
Entity
Organization
Contact information
Practice address
10820 KINGSTON PIKE STE 22, KNOXVILLE, TN 37934-3065
(865) 549-0750
Mailing address
10820 KINGSTON PIKE STE 22, KNOXVILLE, TN 37934-3065
(865) 549-0750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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