Individual
BRENT R MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4230 HARDING PIKE STE 230, NASHVILLE, TN 37205-2013
(629) 255-2066
(629) 255-4136
Mailing address
222 22ND AVE N, NASHVILLE, TN 37203-1852
(629) 255-3486
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
37502
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3884146
—
TN
Enumeration date
10/09/2006
Last updated
02/27/2023
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