Individual
KEVIN EMMANUAL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
109 OSIGIAN BLVD STE 300, WARNER ROBINS, GA 31088-8924
(478) 333-2430
(478) 333-2173
Mailing address
PO BOX 6619, MACON, GA 31208-6619
(478) 333-2430
(478) 333-2173
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
288
OK
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001181
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116370B
—
GA
Enumeration date
06/14/2011
Last updated
02/01/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us