Individual
DOUGLAS B MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W MARKET ST, ATHENS, AL 35611-2457
(256) 265-9891
(256) 518-8276
Mailing address
PO BOX 11407, DRAWER 314, BIRMINGHAM, AL 35246-0100
(205) 437-6098
(205) 437-5998
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
00017804
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000078970
—
AL
01
—
051078970
BCBS
AL
01
—
5149005
AETNA
AL
Enumeration date
10/04/2005
Last updated
12/04/2007
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