# GREGG P. MOODY, PC

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

## Provider details

- **NPI number:** 1902841059
- **Authorized official:** GREGG P MOODY MD (PRESIDENT)
- **Authorized official phone:** (256) 233-2914

## Contact information

- **Practice address:** 1005 W MARKET ST, SUITE 14, ATHENS, AL 35611-2454
- **Practice address phone:** (256) 233-2914
- **Practice address fax:** (256) 230-9005
- **Mailing address:** 1005 W MARKET ST, SUITE 14, ATHENS, AL 35611-2454
- **Mailing address phone:** (256) 233-2914
- **Mailing address fax:** (256) 230-9005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 00027450 | AL | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 05/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 009937807 | — | AL |