Individual
JON RICE MOODY
Active
Individual
JON RICE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15098
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000082080
—
AL
01
—
0004123794
AETNA
—
01
—
110031761
RAILROAD MEDICARE
—
01
—
51082080
BLUE CROSS BLUE SHIELD
AL
01
—
631024475
TAX ID
—
Enumeration date
11/18/2005
Last updated
03/15/2013
Update your record
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