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Individual

CHARLES EDWARD MOORE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2407 HELTON DR STE B, FLORENCE, AL 35630-1067
(256) 764-9613
(256) 764-8474
Mailing address
2407 HELTON DR STE B, FLORENCE, AL 35630-1067
(256) 718-7001
(256) 718-7006

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15163
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051501284
AL
Enumeration date
03/24/2006
Last updated
12/10/2010
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