Individual
PAUL E MORAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1321 SUNSET DR, SUITE 22, JOHNSON CITY, TN 37604-3698
(423) 854-9040
(423) 854-9050
Mailing address
1321 SUNSET DR, SUITE 22, JOHNSON CITY, TN 37604-3698
(423) 854-9040
(423) 854-9050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18878
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3033706
—
TN
01
—
3119946
BCBS
TN
Enumeration date
04/22/2006
Last updated
10/19/2010
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