Organization
FALLEN LEAF MEDICAL
Active
Other names
Fallen Leaf Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL RADFORD MOORE MD (OWNER)
(865) 549-0750
Entity
Organization
Contact information
Practice address
10820 KINGSTON PIKE STE 22, KNOXVILLE, TN 37934-3065
(865) 549-0750
Mailing address
10820 KINGSTON PIKE STE 22, KNOXVILLE, TN 37934-3065
(865) 549-0750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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