Individual
DR. TAMALA ROCHELLE MALLETT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3739 LEGACY ST, WEATHERFORD, OK 73096-9746
(580) 772-2400
(580) 772-2408
Mailing address
3739 LEGACY ST, WEATHERFORD, OK 73096-9746
(580) 772-2400
(580) 772-2408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26755
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200224110A
—
OK
Enumeration date
10/08/2008
Last updated
01/31/2011
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