Individual
ELIZABETH ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
190 HANDLEY RD, TYRONE, GA 30290-2178
(770) 997-5714
(770) 997-2810
Mailing address
190 HANDLEY RD, STE A, TYRONE, GA 30290-2178
(770) 997-5714
(770) 997-2844
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
GA43434
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000753827D
—
GA
Enumeration date
12/28/2005
Last updated
12/09/2020
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