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Individual

DR. RAYMOND AVERY MOODY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
348 ENTERPRISE DR STE B, VALDOSTA, GA 31601-5697
(229) 293-0132
Mailing address
504 GORNTO RD, VALDOSTA, GA 31602-1602
(229) 253-1267

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051990
GA
207Q00000X
Family Medicine Physician
51990
GA

Other

Enumeration date
05/18/2007
Last updated
08/13/2024
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