Organization
LARRY R MOORMAN M D, PC
Active
Other names
Tifton Ophthalmology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA H MOORMAN (OFFICE MANAGER)
(229) 386-2181
Entity
Organization
Contact information
Practice address
1803 OLD OCILLA RD, TIFTON, GA 31794-1617
(229) 386-2181
(229) 386-2193
Mailing address
1803 OLD OCILLA RD, TIFTON, GA 31794-1617
(229) 386-2181
(229) 386-2193
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
014938
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0774710001
CIGNA
GA
01
—
CC4435
RAILROAD MEDICARE
—
01
—
GRP2612
MEDICARE
—
Enumeration date
12/27/2006
Last updated
10/16/2015
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