Individual
DR. JAMES D MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
227 W MAIN ST, ABINGDON, VA 24210-2715
(276) 628-6011
(276) 628-3923
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(276) 628-6011
(276) 628-3923
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101025906
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002074
ANTHEM
—
05
—
006260802
—
VA
05
—
1508848375
—
VA
01
—
C08321
MEDICARE GROUP
—
01
—
CK3042
MDCR RR
—
01
—
TN0101
JOHN DEERE
—
Enumeration date
11/17/2005
Last updated
06/18/2014
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