Individual
GAIL ELIZABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3762 DURHAM RD STE A, ROXBORO, NC 27573-2741
(336) 330-0400
Mailing address
3762 DURHAM RD STE A, ROXBORO, NC 27573-2741
(336) 330-0400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
249
TN
363A00000X
Physician Assistant
PA-968
AR
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4069024
BLUECROSS
TN
Enumeration date
06/13/2006
Last updated
05/24/2022
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