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Individual

JAMES F MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Mailing address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
8966
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3050226
BLUE CROSS BLUE SHIELD
TN
05
3602243
TN
01
430035974
MEDICARE RAILROAD
TN
05
74320946
KY
Enumeration date
10/24/2005
Last updated
07/13/2010
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