Individual
LEE S MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 N OAK AVE, COOKEVILLE, TN 38501-2440
(931) 528-5547
(931) 526-2699
Mailing address
140 W 7TH ST, COOKEVILLE, TN 38501-1726
(931) 783-5582
(931) 526-6760
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD15695
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1940006
UNITED HEALTH CARE
TN
05
—
3378641
—
TN
01
—
340011880
RAILROAD MEDICARE
TN
01
—
6524763
CIGNA HEALTHCARE
TN
01
—
94833
BLUE CROSS BLUE SHEILD
TN
Enumeration date
08/29/2005
Last updated
05/27/2022
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