Individual
DR. TANNER MATTSON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6600 VAN AALST BLVD BLDG 9250, FORT BENNING, GA 31905-2102
(304) 672-3225
(304) 672-3225
Mailing address
233 AUSTIN LOOP, FORT BENNING, GA 31905-7300
(304) 672-3225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2021-00210
NC
Other
Enumeration date
06/26/2017
Last updated
06/15/2023
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