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Individual

RAY JEMISON MOORE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2904 WESTCORP BLVD SW, SUITE 107/108, HUNTSVILLE, AL 35805-6437
(256) 533-1480
(256) 536-4158
Mailing address
2904 WESTCORP BLVD SW, SUITE 108, HUNTSVILLE, AL 35805-6437
(256) 533-1480
(256) 536-4158

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
20131
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009927350
AL
01
051094264
BCBS
AL
Enumeration date
06/10/2005
Last updated
07/18/2008
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