Individual
CHARLES BRUCE MOOMEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(678) 207-4000
(770) 531-2435
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 533-4786
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
049923
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00899951A
—
GA
01
—
GRP7416
MEDICARE GROUP NUMBER
GA
Enumeration date
07/07/2005
Last updated
06/11/2025
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