Individual
DR. JUDSON B. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 ROSS CLARK CIR, DOTHAN, AL 36301-4754
(334) 793-2663
(334) 836-2247
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2247
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26641
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009996985
—
AL
05
—
121888
—
AL
01
—
511-08313
BCBS OF AL - HEALTHWEST
AL
01
—
515-28492
BCBS OF AL 1500 RCC
AL
05
—
681240743A
—
GA
05
—
681240743C
—
GA
Enumeration date
08/25/2005
Last updated
11/20/2014
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