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Individual

TEANNA J MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
184 S MAYO TRL, PIKEVILLE, KY 41501-1518
(606) 218-4800
Mailing address
PO BOX 2917, PIKEVILLE, KY 41502-2917
(606) 218-4800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03496
KY
207Q00000X
Family Medicine Physician
3133
TN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/25/2010
Last updated
03/17/2018
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