# NORTH DEKALB PRIMARY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851898449
- **Authorized official:** MR. JOHN MOORE CRNP (OWNER)
- **Authorized official phone:** (256) 996-0540

## Contact information

- **Practice address:** 136 COMMERCE AVE, VALLEY HEAD, AL 35989
- **Practice address phone:** (256) 674-1052
- **Practice address fax:** (256) 674-1054
- **Mailing address:** 38109 US HIGHWAY 11, VALLEY HEAD, AL 35989-4432
- **Mailing address phone:** (256) 996-0540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2018
- **Last updated:** 04/17/2023