Individual
MARTHA JEANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 W MAIN ST, LIVINGSTON, TN 38570-1718
(931) 823-5681
(931) 823-8203
Mailing address
PO BOX 346, LIVINGSTON, TN 38570-0346
(931) 403-1197
(931) 403-2615
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45921
TN
207Q00000X
Family Medicine Physician
MD058674L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0709123
UNITED HEALTHCARE
PA
01
—
0737905
AETNA
PA
01
—
251830873
COMMERCIAL
PA
01
—
93789
HEALTH AMERICA ASSURANCE
PA
01
—
987266
HIGHMARK
PA
01
—
MO838156
HIGHMARK
PA
05
—
Q024962
—
TN
Enumeration date
01/06/2006
Last updated
01/25/2017
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