Individual
TAMARA LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
909 OLIVE ST, SHREVEPORT, LA 71104-2103
(318) 698-3291
(318) 698-3293
Mailing address
909 OLIVE ST, SHREVEPORT, LA 71104-2103
(318) 698-3291
(318) 698-3293
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.208034
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2188852
—
LA
Enumeration date
04/09/2012
Last updated
06/29/2022
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