Individual
DR. LEAH NICOLE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
105 W STONE DR, STE 1F, KINGSPORT, TN 37660-3365
(423) 857-2793
(423) 578-8025
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD37074
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3879857
—
TN
05
—
38798571
—
TN
01
—
4106588
BCBS
TN
05
—
7100019690
—
KY
01
—
TN01U8
JOHN DEERE
TN
Enumeration date
04/26/2006
Last updated
05/07/2014
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